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Sufentanil – Effect, Application & Risks

Sufentanil

Sufentanil is the strongest painkiller in Germany that is approved for use in human medicine. It belongs to the group of synthetic opioids .

What is Sufentanil?

Sufentanil is a potent analgesic that bears a structural resemblance to painkillers containing fentanyl . It is primarily used in the field of anesthesia and is the strongest permitted painkiller in Germany.

The development of sufentanil took place 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 became a proven means of anesthesia in the context of surgical procedures. Sufentanil is offered in Central Europe under the drug name Sufenta®. In addition, there are several generics on the market.

In Germany, dealing with sufentanil without a prescription or permission is in principle punishable. The opioid can be abused as a psychotropic or depressant intoxicant. According to the Narcotics Act (BtMG), sufentanil is considered a prescription drug for anesthesia in this country.

Pharmacological action

Sufentanil is classified as a highly effective pain reliever. Its pain inhibition is significantly higher than that of morphine . The effect begins just a few minutes after the opioid is administered. Since sufentanil accumulates only to a limited extent in the human body and is quickly eliminated, its potency can be estimated well. It depends on the respective dose and is adjusted to the intensity of the surgical intervention.

Sufentanil acts 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 is how the characteristic effects of opioids such as respiratory depression , analgesia , constriction of the pupils and euphoria arise .

Sufentanil exhibits seven to ten times the analgesic potency of fentanyl. With morphine it is 700 to 1000 times higher. This makes sufentanil the most effective medically used opioid. Due to its good solubility in fats , the analgesic can spread quickly in fatty tissues .

Sufentanil lasts for around 30 to 45 minutes. The degradation of the drug takes place primarily in the liver . A smaller part gets out of the organism via the kidneys without any changes.

Compared to other opioids such as fentanyl, sufentanil has the advantage that serious side effects only occur at high doses. Cardiovascular system , blood coagulation 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 painkiller. 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 administered intravenously by a syringe pump through a vein . Another administration option is epidural anesthesia near the spinal cord. However, it is important to only ever administer the opioid under medical supervision because of its strong analgesic potency. In this way, possible respiratory depression cannot be overlooked.

Critical care uses sufentanil for continuous analogue sedation because it is easier to control than fentanyl. In addition, its sedative effects are more pronounced and respiratory depression is rare. Preferred areas of application for sufentanil are surgical, gynecological and orthopedic interventions.

Risks & side effects

As with other opioids, sufentanil can also have undesirable side effects. These primarily include the suppression of respiratory function, nausea , vomiting , constriction of the pupils, itching and dullness.

Other conceivable side effects are headaches , discoloration of the skin, dizziness , drowsiness , high or low blood pressure , urinary incontinence , urinary retention , constipation , paleness , tachycardia , fever , muscle stiffness or muscle twitching .

Babies may experience a bluish discoloration of the skin and tremors . In the case of a rapid and single dose of sufentanil, patients often suffer from coughing problems . When sufentanil is administered epidurally, side effects such as urinary retention, nausea and itching are more common.

If the patient suffers from hypersensitivity to sufentanil or other opioids, administration of the analgesic should be refrained from. In addition, the drug must not be used when a child is born , as it can threaten to suppress the infant’s respiratory function.

The risk/benefit assessment of sufentanil administration must be considered in the case of hypothyroidism , kidney or liver dysfunction, traumatic brain injury, increased intracranial pressure , lung diseases associated with respiratory impairment , obesity , alcohol addiction , babies with birth defects or elderly patients must be carried out by a doctor.

Sufentanil should only be used during pregnancy if the doctor considers it absolutely necessary. This allows the opioid to penetrate the placenta, which in turn causes withdrawal symptoms in the child. Because sufentanil also passes into breast milk , the painkiller must never be administered during breastfeeding . The mother can only breastfeed her child again 24 hours after the end of the anesthetic.

There is a risk of interactions if sufentanil is taken at the same time as drugs that suppress brain function. The suppression of the respiratory function is increased by the administration of opioid painkillers, neuroleptics , anesthetics, the sleeping pill etomidate or alcohol .

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.