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Sufentanil is used for invasive surgical procedures for pain reduction. It is commonly used for surgeries in which the patient is unconscious and intubated, especially if the patient will need to remain intubated for an extended period following the procedure.
Sufentanil is used when other less potent variations of fentanyl are not strong enough due to extreme opioid-dependency. When people who are heavily opioid-dependent require surgery, standard doses of opioids are not strong enough to overpower the individual’s high drug tolerance. Patients who use buprenorphine for the long-term maintenance of an opioid abuse disorder may require Sufentanil for this reason. Sufentanil is often the only opioid strong enough to break buprenorphine’s bonds to opioid receptors in the body.
Common side effects of Sufentanil include skeletal muscle rigidity, decreased tidal volume, and respiratory depression. Skeletal muscle rigidity tends to focus around the muscles of the neck and extremities. Urinary retention is another possible side effect of Sufentanil use. Upon discontinuation of Sufentanil, the return of normal bladder function is typically delayed.
Sufentanil administration is carefully titrated according to the unique metabolic factors of each patient. Doses may need to be adjusted throughout the surgical procedure to account for unforeseen variables. If too much Sufentanil is administered, the result can be a dangerously low respiratory drive.
Sufentanil acts directly on the brainstem to suppress the patient’s innate urge to breathe. The brainstem regulates breathing by reacting to carbon dioxide levels in the blood. When carbon dioxide levels become elevated, the brainstem signals for the lungs to breathe. In the event of severe overdose, this mechanism can become entirely disrupted, potentially resulting in carbon dioxide toxicity and oxygen deprivation.
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Pre-existing opioid tolerance is one of the most influential factors, especially in people who are highly tolerant to opioids. Higher doses may be necessary to overpower the patient’s baseline opioid concentrations in the blood. In obese patients, doses should be calculated based on lean body weight. Doses should be reduced for elderly and debilitated patients due to suboptimal organ function.
The placement of an endotracheal tube or nasopharyngeal airway will be called for if it has not already been placed. Respiratory depression is made more severe by the skeletal muscle rigidity associated with Sufentanil use. A neuromuscular blocking agent may be needed to facilitate ventilation. Other supportive measures, such as oxygen therapy and the use of vasopressors, may be indicated for the management of pulmonary edema and cardiovascular depression.
Once the patient’s airway is secured, naloxone may be administered to reverse the effects of Sufentanil. Naloxone is a powerful opioid antagonist that rapidly negates the effects of opioids. Several doses of naloxone will likely be necessary due to the potency of Sufentanil.
If you or someone you love is struggling with opioid misuse or abuse, The Recovery Village is available to answer any questions you may have. Visit us online at www.TheRecoveryVillage.com or call toll-free at 855-548-9825 to learn more about recovery resources in your area.