Sufentanil

This study aims to determine the impact of fentanyl and sufentanil in combination with propofol on heart rate and blood pressure changes following laryngoscopy and tracheal intubatio.

In this clinical trial, 96 patients undergoing laryngoscopy were allocated to three groups of 32 individuals each. The three groups received three µg /kg fentanyl, 0.3 µg /kg sufentanil, and a similar volume of normal saline along with other drugs during induction of anesthesia. Hemodynamic parameters were assessed and compared at baseline, just before laryngoscopy, and at minutes 1, 3, 5, and 10 after laryngoscopy across the three groups.

During the study period, among the fentanyl, sufentanil, and normal saline groups, 15 (46.9%), 2 (6.3%), and 28 (87.5%) patients experienced tachycardia, respectively (P < 0.01). Bradyarrhythmia occurred in 8 (25%), 3 (9.4%), and 1 (3.1%) patients in the respective groups (P = 0.036). Additionally, 16 (50%), 9 (28.1%), and 24 (75%) patients in the same order experienced increased blood pressure (P = 0.001), and the differences between the three groups were significant. Hypotension frequency was 2 (6.3%), 2 (6.3%), and 0 (0%) in the three groups, with no significant difference between them (P = 0.54).

Both propofol-fentanyl and propofol-sufentanil drug combinations, compared to the control group receiving propofol-normal saline, led to the modulation of blood pressure and heart rate in patients undergoing tracheal intubation. However, fewer hemodynamic disturbances, including tachycardia, bradyarrhythmia, and hypertension, were observed in sufentanil groups.

Due to the high prevalence of complications during and after laryngoscopy, especially hemodynamic disturbances, and the absence of a suitable solution for preventing these complications, this study was conducted to compare the effect of“Ketamine-Midazolam-Sufentanil” with “Etomidate-Sufentanil” combinations on changes in heart rate and blood pressure after laryngoscopy and endotracheal intubation.

In this controlled, triple-blind randomized clinical trial, 96 laryngoscopy candidate patients were divided into three groups of 32 members and were given “Ketamine-Midazolam-Sufentanil” (KMS), “Etomidate-Sufentanil” (ES) and” Etomidate-Normal Saline” (NS) respectively before laryngoscopy.Hemodynamic parameter changes at baseline and 1,3,5and 10 minutes after laryngoscopy, were measured and compared between the 3 groups.

During the study, the 3 groups KMS, ES, and NS had 0%, 15.6% and, 3.1% bradycardia respectively (p value = 0.024). Changes in systolic blood pressure were significantly different in the 3 groups (p value = 0.043). However, the incidence of tachycardia, hypertension, and hypotension were not significantly different among the 3 groups.

Results of this study showed that using the “Ketamine-Midazolam-Sufentanil” combination before laryngoscopy can reduce hemodynamic disturbances during and after laryngoscopy. Patients who receive this drug combination seem to have more desirable hemodynamic stability during and after laryngoscopy

Labor pain is the most unbearable pain and can be relieved by painless delivery. This study aimed at investigating the effect of intrathecal sufentanil on some labor parameters in primiparous women.

In this clinical trial study, 126 primiparous women, who were candidates for vaginal delivery in Niknafs Hospital of Rafsanjan, were enrolled based on the table of random numbers in two intervention and control groups equally. The intervention group received 0.1 µg/kg sufentanil in the L5-S1 space, and the control group did not receive painless delivery. Then, the length of the first stage of labor, pain score, perineal laceration, frequency of cesarean section, mother's satisfaction, Apgar of neonate, delivery with vacuum, and need for analgesic in postpartum period were investigated. To compare numeric variables, two-way repeated measures analysis of variance (ANOVA), and to compare the categorical variables chi-square test were used.

The average length of the first stage of labor in the intervention and control groups were 141.33±58.43 and 278.61±140.81 minutes, respectively, and the difference was statistically significant (p<0.001). In the intervention group, average pain score, perineal laceration, cases leading to caesarean section, and the frequency of need for analgesic in postpartum were significantly less than the control group (p<0.05).

Painless delivery with saddle block and sufentanil drug reduced length of the first stage of delivery and pain score. Also it improved other delivery parameters, so it is recommended for painless delivery.

Today, spinal anesthesia is the method of choice for most cesarean sections. Postoperative pain control has always been one of the main concerns of anesthesiologists. Therefore, this study was performed aimed to compare the amount of pain with the use of bupivacaine and bupivacaine-sufentanil combination in women undergoing cesarean section with spinal anesthesia.

This double-blind randomized clinical trial study was performed in 2021 on 30 patients undergoing elective cesarean section referred to Motahari Hospital in Jahrom. Patients were randomly divided into two groups of bupivacaine and bupivacaine-sufentanil. Patients' pain was assessed at 2, 6, 12 and 24 hours after surgery. Data were analyzed by SPSS software (version 21) and T-test, Mann-Whitney and Chi-square tests. P<0.05 was considered statistically significant.

The results of Mann-Whitney test showed that the mean pain in 2 hours after surgery was higher in the bupivacaine group than the bupivacaine + sufentanil group (P = 0.03). At other times, the mean pain was not significantly different between the bupivacaine + sufentanil and the bupivacaine groups (P >0.05). The most common postoperative complication in bupivacaine + sufentanil group was pruritus (53.3%).

The use of spinal sufentanil with intrathecal bupivacaine in cesarean section reduces the pain in the first hours after cesarean section.

two drugs, fentanyl and sufentanil, are drugs added to the anesthetic trial, which have been used more than other drugs, however, there is still no detailed information about the safety of adding these two drugs to the anesthetic drug in the event of urinary retention in Therefore, the present study was conducted with the aim of comparing the addition of fentanyl and sufentanil to the anesthetic drug and its effects on urinary retention after spinal anesthesia.

This study was conducted as a systematic review and meta-analysis based on the PRISMA statement. Searching MEDLINE, CENTRAL and EMBASE, Web of Science, Scopus, Mag Iran and SID databases using the keywords anesthesia, spinal anesthesia, phenethyl, sufentanil, bupivacaine, ropicaine, levobopiva, regional anesthesia, urinary retention and after Anesthesia was performed with the help of Boleyn operatives.

There was no significant difference in urinary retention (RR=1.02 [0.70-1.49]; 95% CI) between the intervention and control groups; Also, there was no significant difference between fentanyl or sufentanil (Chi=0.13/I=0%).

Adding fentanyl or sufentanil to the anesthetic drug during spinal anesthesia has no effect on urinary retention after surgery

Intratechal opioids in combination with local anaesthetic drugs are commonly used for analgesic induction during cesarean section. Lipophilic opioids such as Fentanyl and Sufentanil are among most commonly used intratechal opioids. Pruritus is one of the most common complications of opioids. So, this study was performed with aim to compare the frequency and severity of pruritus following intratechal administration of fentanyl or sufentanil with Bupivacaine in elective cesarean section.

This double-blind randomized clinical trial study was performed in 2019 on 50 pregnant women candidate for elective cesarean section and referred to Shahid Mostafa Khomeini hospital in Tehran. The subjects were randomly divided into two groups. One group received 25 microgram intratechal fentanyl and another group received 2.5 microgram sufentanil both in combination with 12.5 miligram hyperbaric bupivacaine 0.5%. After the surgery, data about age, BMI, surgery duration and pruritus were evaluated. Data were analysed by SPSS software (version 21) and Chi-square and Independent t-test. P<0.05 was considered statistically significant.

There was no significant difference between the two groups in terms of age (P=0.428), BMI (P=0.339) and surgery duration (P=0.296). Frequency of pruritus was 68% in fentanyl and 88% in sufentanil groups; this difference was not statistically significant (P=0.088). Pruritus severity (P=0.361) and use of anti-pruritus drug (P=0.333) showed no significant difference between the two groups.

Pruritus is a common side-effect of intratechal fentanyl and sufentanil. There was no evidence in favour of higher prevalence of pruritus in the sufentanil group than the fentanyl group.

Spinal anesthesia is the most common method of analgesia for elective cesarean section. Nausea and vomiting in the patients can cause problem during the surgery. This study was performed with aim to compare the frequency of nausea and vomiting following spinal anesthesia using the drug combination of Bupivacain-Fentanyl and Bupivacain-Sufentanil in cesarean surgery.

This double-blind clinical trial study was performed in 2013 on 60 patients with term pregnancies who were candidate for cesarean under spinal anesthesia. Group F received 25 µg fentanyl while group S received 2.5 μg Sufentanil with 12.5mg intratechal Bupivacaine. The main complications were nausea and vomiting during and in the hours 1, 2 ,6, 12 and 24 after the surgery. Other investigated complications included hypotension, urinary retention and time of sensory block regression to the level of T8. Data were analyzed by SPSS software (version.16), and Chi-square test and Student t-test, Logistic regression and repeated data logistic. p < 0.05 was considered statistically significant.

The two groups were not significantly different in terms of rate of nausea (P=0.395) and vomiting during (P=0.5) and in hours 1, 2, 6, 12 and 24 after the surgery, hypotension (P=0.589), heart rate changes (P=0.105), urinary retention, the time of sensory block to T8 (P=0.556) and the time of returning motor block (P=0.787).

Using two medications of Fentanyl and Sufentanil in combination with hyperbaric Bupivacain had no impact on the frequency and prevalence of nausea and vomiting.

Due to the importance of pain control in the postoperative period, the use of pain killers reduces postoperative complications by improving the patients’ pain intensity. This study was performed to compare the efficacy of oral Meloxicam with pain pump containing Paracetamol and Sufentanil in post-cesarean analgesia.

In this clinical trial study, 59 pregnant women undergoing spinal cesarean section in Ali ebn-e Abi taleb Hospital of Zahedan in 2017 were studied. Patients were randomly divided into two groups receiving oral Meloxicam and Paracetamol and Sufentanil pain pump. The severity of pain, satisfaction, sedation and need for analgesics were assessed in both groups.

Mean age of patients was 26.9 ± 4.9 years. In the present study, mean pain intensity in patients receiving Meloxicam and pump at zero moment were 3.9 ± 1.5 and 4.2 ± 1.4 (P = 0.426), at 6 hours post-surgery, respectively  3.3±0.9 and 2.6 ± 0.8 (P = 0.006) ,at 12 h post-surgery  were 2.1 ± 0.9 and 1.7 ± 0.7 (P = 0.059) and at 24 h, respectively were 1.0 ± 7.8 and 1.1 ± 0.7, respectively (P = 0.001) .The need for analgesic in Meloxicam  group was 18.1 ± 11.4 mg and in pain pump group was 10.8 ±12.6 mg. (P = 0.024).

The results of this study showed that pain intensity in patients receiving pain pump was significantly lower than those taken oral Meloxicam. Also, the demand for analgesic was lower in this group.

Spinal anesthesia is the most common anesthesia in cesarean section that creates a strong sensory and motor block. Fentanyl and sufentanil are among the intrathecal opiate medication that each have different side effects, and this has led to a lack of consensus on the most appropriate or dosage medication. In this study, sufentanil and fentanyl were compared with placebo.

In this clinical trial study, 120 pregnant women who were candidates for elective cesarean section and the ages between 18 and 30 years were selected. After obtaining informed consent, they were randomly divided into three groups of 40 each. The groups included bupivacaine plus 20 μg fentanyl, or 2.5 μg sufentanil, or 0.5 cc normal saline. The duration and quality of analgesia, heart rate, blood pressure, and side effects including vomiting, itching, and chills were recorded.

The mean age of patients was 29.1 ± 5.1 (P = 0.75). The mean duration of analgesia in the fentanyl and sufentanil groups was more than the placebo group (P = 0.008). There was no significant difference in analgesic quality between the three groups (P = 0.68). Postoperative nausea was significantly higher in the fentanyl group than in the other groups (P = 0.021). The itching rate in the bupivacaine group was also significantly lower than the other two groups (P = 0.018).

According to the results of this study, the use of sufentanil increases the duration of analgesia and its side effects are less than fentanyl, so in cases such as elective cesarean section it can be used to increase the duration of nerve block.

Hemodynamic disorders is a common and serious complication during endotracheal intubation with various suggested preventive methods; but there is no consensus. The aim of this study was to determine the effect of three different doses of sufentanil on heart rate and blood pressure changes after laryngoscopy and endotracheal intubation, and to compare it with the control group.

In a double-blind clinical trial study, 128 patients undergoing surgery with general anesthesia were randomly divided into 4 groups of 32. In the first group, as the control group, the drug was not injected, and the other three groups received 0.1, 0.2, and 0.3 µg/kg sufentanil, respectively, which was injected before laryngoscopy. Hemodynamic parameters were determined at 0, 1, 3, 5, and 10 minutes after laryngoscopy, and were compared between the four groups.

The trend of blood pressure changes during laryngoscopy was significantly different between the four groups; but the changes in heart rate and oxygen saturation were not different between the groups. Changes in the level of hemodynamic parameters showed that the group receiving 0.3 µg/kg sufentanil had higher stability during the laryngoscopy.

Dosage of 0.3 µg/kg sufentanil appears to be associated with favorable hemodynamic stability of patients during laryngoscopy and endotracheal tube insertion.

Children with hematologic malignancy during the course of illness require diagnostic and therapeutic interventions which are associated with pain and stress. The purpose of this study was to evaluate and compare the sedative and analgesic effects of propofol-ketamine and sufentanil-ketamine during diagnostic and therapeutic interventions in the children.
Material and

This randomized, double-blind clinical trial included children with acute lymphoblastic leukemia, between 6 months and 14 years of age, who were candidate for lumbar puncture or bone marrow aspiration. Children were randomly assigned to two groups of 34, propofol-ketamine (PK) and sufentanil-ketamine (SK) groups. PK group received injections of propofol (1 mg/kg) and ketamine (0.7 mg/kg). SK group received injections of sufentanil (0.5 µg/kg) and ketamine (0.7 mg/kg) until the desired sedation level was reached. The two groups were compared with each other in regard to quality of sedation, analgesia and hemodynamic changes during the intervention and in the recovery room.

There was no significant difference between the two groups in relation to demographic characteristics,(P> 0.05). The relative frequency of deep sedation levels in the SK group was greater than that in the PK group (P = 0.09). The mean pain severity in the SK group was significantly lower than that in the PK group (P = 0.02).

The results of this study showed that use of ketamine with propofol or sufentanil in painful procedures can provide sedation and analgesia. Sufentanil-ketamine is preferred to propofol- Ketamine because of inducing superior quality of sedation and analgesia and also stability of hemodynamic parameters, in children with acute lymphoblastic