As Sufentanil is the name given to the strongest pain reliever in Germany that is approved in human medicine. It belongs to the group of synthetic opioids.
What is Sufentanil?
Sufentanil is a powerful analgesic that has a structural similarity to fentanyl-based pain relievers. It is primarily used in the field of anesthesia and is the strongest permitted pain reliever in Germany.
Sufentanil was developed in the 1970s. The painkiller was first published in 1976 by the Belgian chemist Paul Janssen (1926-2003). Janssen had previously synthesized fentanyl. Sufentanil came into use in the late 1980s and has advanced to become a tried and tested means of anesthesia for surgical procedures. Sufentanil is offered in Central Europe under the product name Sufenta®. There are also several generic drugs on the market.
In Germany, dealing with sufentanil without a prescription or permit is generally considered a criminal offense. The opioid can be misused as a psychotropic or depressant intoxicant. According to the Narcotics Act (BtMG), sufentanil is a prescription drug for anesthesia in this country.
Pharmacological effect
Sufentanil is classified as a highly effective pain reliever. Its pain inhibition is well above that of morphine. The effects set in just a few minutes after the opioid was administered. Since sufentanil only accumulates to a limited extent in the human body and is quickly excreted, its potency can be easily assessed. It depends on the dose in question and is adapted to the intensity of the surgical procedure.
Sufentanil works via the opioid receptors. These are particularly located in the central nervous system (CNS). Sufentanil binds to both the µ-opioid receptor and the K receptor. This creates the characteristic effects of opioids such as respiratory depression, analgesia, constriction of the pupils and euphoria.
Sufentanil has seven to ten times the analgesic potency compared to fentanyl. With morphine it is 700 to 1000 times. Sufentanil is thus the most powerful medically used opioid. Because of its good solubility in fats, the analgesic can spread quickly in fatty tissues.
The duration of action of sufentanil is approximately 30 to 45 minutes. The breakdown of the drug mainly takes place in the liver. A smaller part gets out of the organism through the kidneys without changes.
Compared to other opioids such as fentanyl, sufentanil has the advantage that serious side effects only occur at a high dose.The cardiovascular system, blood clotting and immune system are also hardly subject to changes. In addition, sufentanil does not release the neurotransmitter histamine.
Medical application & use
Sufentanil is mainly used in anesthesia and intensive care medicine, where it is used as a pain reliever. The analgesic is used in both adult patients and children. The drug is used to combat pain, but is also used with other active ingredients as an anesthetic component.
Sufentanil is usually given intravenously through a syringe pump through a vein. Another administration option is epidural anesthesia near the spinal cord. However, it is important to always administer the opioid under medical supervision because of its strong analgesic potency. In this way, possible respiratory depression cannot be overlooked.
Intensive care medicine uses sufentanil for continuous analog sedation because it is easier to control than fentanyl. In addition, its calming effects are stronger and respiratory depression is rare. Sufentanil's preferred areas of application are surgical, gynecological and orthopedic interventions.
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➔ Medicines for painRisks & side effects
As with other opioids, undesirable side effects are possible with sufentanil. These primarily include the suppression of respiratory function, nausea, vomiting, constriction of the pupils, itching and dulling.
Other possible side effects are headache, discoloration of the skin, dizziness, drowsiness, too high or too low blood pressure, urinary incontinence, urinary retention, constipation, paleness, palpitations, fever, muscle stiffness or muscle twitching.
Babies may experience bluish skin discoloration and tremors. In the case of a rapid and single dose of sufentanil, patients often suffer from coughing problems. If sufentanil is administered epidurally, side effects such as urinary retention, nausea and itching are more common.
If the patient is hypersensitive to sufentanil or other opioids, the painkiller should not be given. In addition, the agent must not be used during the birth of a child, because it can threaten the respiratory function of the infant.
In the case of hypothyroidism, kidney or liver dysfunction, injuries to the craniocerebral region, increased intracranial pressure, lung diseases associated with impaired breathing, obesity, alcohol addiction, babies with birth defects or elderly patients, the risk and benefit of Sufentanil administration must be weighed up must be carried out by a doctor.
Sufentanil should only be given during pregnancy if the doctor deems it absolutely necessary. This allows the opioid to penetrate the placenta, which in turn results in withdrawal symptoms in the child. Because sufentanil is also excreted in breast milk, the pain reliever must never be administered during breastfeeding. The mother can only breastfeed her child again 24 hours after the anesthetic has ended.
There is a risk of interactions when taking sufentanil and drugs that suppress brain function at the same time. The suppression of the respiratory function is increased by the administration of opioid painkillers, neuroleptics, anesthetics, the sleeping pill etomidate or alcohol.
