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Sufentanil

SufentanilSufentanil is an opioid analgesic drug used in medicine. It is an analogue of fentanyl that is approximately 5 to 10 times more powerful than the parent fentanyl drug compound. This makes it 500 times more potent than the painkiller drug morphine. Sufentanil is also noted for its shorter duration of action than fentanyl. It goes by alternative names R30730, Sufenta and Sufentil.

It was first synthesized by the Belgian company Janssen Pharmaceutica in 1974. This particular company is responsible for inventing many of the fentanyl analogues we have today. They did extensive research in this field in the late 1960s and early 1970s, patenting many of the useful fruits of this research.

Sufentanil differs only moderately from fentanyl in structure. A methoxymethyl is added to the piperidine group. This is theorized to contribute to the reduced length of action of the drug in comparison to fentanyl. In addition to this the phenyl ring in fentanyl is replaced with a sulphur containing thiophene ring.

It is marketed as a drug for use in specialised centres under the trade names Sufentil and Sufenta. It is also available as a transdermal patch in Europe under the trade name Chronogesic, similar to the fentanyl patch Duragesic. Some of the patch preparations also add the local anaesthetics lidocaine or mepivacaine.

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The main use of Sufentanil in medicine is in critical care and operations where pain relief is required for a short time. Like other fentanyl analogues, it is more sedating than other opioids, and this makes it a good component in an anaesthetic regimen for surgery. Here it will be administered under doctor’s orders by the intravenous route.

Sufentanil tends to be reserved for use in patients that are heavily opioid dependent or tolerant due to long term opiate use in the management of chronic pain or from illicit opiate use. Due to their tolerance, they require a stronger opioid painkiller for adequate pain relief and sedation. Sufentanil is currently the strongest opioid painkiller licensed for human use. There are other fentanyl analogues such as ohmefentanyl, but these are used as tranquilisers for large animals like elephants.

In patients that are taking buprenorphine for management of chronic pain, ohmefentanyl is the only drug that can be used to manage short term increases in pain. It is the only opioid licensed for use in humans that has potency and binding affinity that is large enough to displace buprenorphine from opioid receptors and provide additional pain relief.

Like fentanyl itself and the majority of its analogues, sufentanil causes serious respiratory depression. During surgery, it is generally administered in the presence of a medical professional trained in airway management. There needs to be airway equipment available as this drug may cause respiratory arrest if given too rapidly or in too high a dose.

Other side effects of this drug include that it produces an irregular heartbeat, changes in blood pressure and that it often causes nausea and vomiting.

It has been associated with a few rare cases of anaphylaxis.