Drugs and techniques used for analgesia and sedation in critically ill patients differ widely. The ideal drug used should offer the following characteristics: wide therapeutic index, minimal alteration of cardiovascular and/or respiratory function, no immunosuppression, rapid awakening, lack of tolerance or psychic problems after the end of application of the drugs.
Sufentanil is a narcotic, characterised by a 10-fold higher analgesic potency compared to fentanyl, has a sedative action too, which makes it a useful and desirable drug in ICU patients.
Documented experiences with sufentanil in the critically ill are relatively small. In our ICU sufentanil has been used since 1988 for analgosedation. Since that time more than 900 patients have been treated. The drug is given continuously via a perfusor 1 μg kg−1 h−1 initially and then adapted to the patients' needs. At starting it can be necessary to add benzodiazepines to achieve a better adaption to the ventilator. During the weaning period in the intubated and spontaneously breathing patient sufentanil is used in a dose of 0.3 μg kg−1 h−1.
Using sufentanil in the recommended dose most of our patients could be managed well. In about 40% of the patients it is necessary to supplement the regime with a bolus application of midazolam. The drug did not show any negative influence on haemodynamic parameters: serum cortisol levels were not decreased. During the weaning period no increase in PaCO2 could be observed.
In conclusion sufentanil is an excellent and safe drug for analgosedation in critically ill patients.
 Kroll W, List WF. Eignet sich Sufentanil für die Langzeitsedierung kritisch Kranker? Anaesthesist
Seventh International Symposium on Intravenous Anaesthesia, Lausanne, Switzerland, 2-3 May 1997
This publication is supported by grants from various pharmaceutical companies. The views in this publication are those of the authors and not necessarily those of supporting companies. Drugs and administration techniques referred to should only be used as recommended in the manufacturers' prescribing information.