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Alfentanil (Alfentanil Hydrochloride) - Summary

 
 



ALFENTANIL SUMMARY

ALFENTANIL
INJECTION, USP

Alfentanil Injection, USP is an opioid analgesic chemically designated as N-[1-[2-(4-ethyl-4,5-dihydro-5-oxo-1H-tetrazol-1-yl)ethyl]-4-(methoxymethyl)-4-piperidinyl]-N-phenylpropanamide monohydrochloride (1:1) with a molecular weight of 452.

Alfentanil Injection is indicated:

as an analgesic adjunct given in incremental doses in the maintenance of anesthesia with barbiturate/nitrous oxide/oxygen.

as an analgesic administered by continuous infusion with nitrous oxide/oxygen in the maintenance of general anesthesia.

as a primary anesthetic agent for the induction of anesthesia in patients undergoing general surgery in which endotracheal intubation and mechanical ventilation are required.

as the analgesic component for monitored anesthesia care (MAC).

SEE DOSAGE CHART FOR MORE COMPLETE INFORMATION ON THE USE OF ALFENTANIL INJECTION.


See all Alfentanil indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Alfentanil

Study shows anesthesia-related deaths decline; improvement needed to reduce injuries
Source: Pain / Anesthetics News From Medical News Today [2014.10.17]
Although recent trends show a decline in anesthesia-related deaths, a study published today by the Journal of Healthcare Risk Management concludes that risks are evolving and both physicians and...

Risks From Epidural, Spinal Anesthesia Very Low, Study Says
Source: MedicineNet Headache Specialty [2014.10.15]
Title: Risks From Epidural, Spinal Anesthesia Very Low, Study Says
Category: Health News
Created: 10/14/2014 12:00:00 AM
Last Editorial Review: 10/15/2014 12:00:00 AM

Large study delivers message to expectant mothers: Epidural, spinal anesthesia safe choices for relieving pain
Source: Pain / Anesthetics News From Medical News Today [2014.10.14]
Women seeking pain relief during childbirth should be comforted to know that epidural and spinal anesthesia are extremely safe, suggests a study of more than 80,000 women that reviewed anesthesia...

Huge registry shows anesthesia complication rates dropped by more than half in four years
Source: Pain / Anesthetics News From Medical News Today [2014.10.12]
Anesthesia-related complications decreased by more than half in four years, according to the Anesthesia Quality Institute's (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) of more than...

The Death of Joan Rivers: Endoscopy and Anesthesia Risks
Source: MedicineNet Heart Attack and Atherosclerosis Prevention Specialty [2014.09.08]
Title: The Death of Joan Rivers: Endoscopy and Anesthesia Risks
Category: Doctor's Views
Created: 9/8/2014 12:58:00 PM
Last Editorial Review: 9/8/2014 12:58:43 PM

more news >>

Published Studies Related to Alfentanil

Concurrent assessment of hepatic and intestinal cytochrome P450 3A activities using deuterated alfentanil. [2011.04]
Alfentanil (ALF) is a validated probe for hepatic, first-pass, and intestinal cytochrome P450 (CYP) 3A activity, using plasma clearances, single-point concentrations, and noninvasive pupil diameter change (miosis).

Comparison of propofol and the combination of propofol and alfentanil during bronchoscopy: a randomized study. [2011.01]
BACKGROUND: propofol is an excellent sedative agent for use in patients undergoing bronchoscopy. The addition of an opioid to propofol can be advantageous because of the antitussive effect of the opioid and the possible improvement in sedation quality. However, it may increase the risk of hypoxaemia. To investigate the effect of the addition of alfentanil to propofol, we performed a prospective study to compare propofol-only sedation with propofol-alfentanil combination sedation in patients undergoing bronchoscopy... CONCLUSIONS: the combination of propofol and alfentanil resulted in a greater respiratory depression than propofol alone; furthermore, the addition of an opioid did not improve the quality of sedation. In conclusion, we do not recommend sedation with propofol and alfentanil during bronchoscopy. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

Comparison of alfentanil and remifentanil infusions in combination with propofol for the outpatient extra-corporeal shock wave lithotripsy. [2011]
PURPOSE: The aim of this study is to compare the efficiency of propofol+remifentanil to propofol+alfentanil in reducing pain in patients with urinary system stones undergoing outpatient Extracorporeal Shock Wave Lithotripsy (ESWL)... CONCLUSION: We concluded that both methods may be successfully used for patients undergoing ESWL (Tab. 6, Rief. 29).

Optimal bolus dose of alfentanil for successful tracheal intubation during sevoflurane induction with and without nitrous oxide in children. [2010.05]
BACKGROUND: The goals of this study were to determine the effective bolus dose of alfentanil required for successful tracheal intubation during inhalation induction using sevoflurane 5% without neuromuscular block in children, and whether nitrous oxide reduces these doses... CONCLUSIONS: The effective bolus dose of alfentanil for successful tracheal intubation was 11.5 microg kg(-1) in 50% of children during inhalation induction using sevoflurane 5% without neuromuscular blocking agent. Addition of nitrous oxide 60% in oxygen reduced the effective alfentanil dose by 25%.

Interaction of physostigmine and alfentanil in a human pain model. [2010.03]
BACKGROUND: Preclinical and clinical studies suggest an important role for cholinesterase inhibitors in pain therapy. The aim of this study was to examine the analgesic and antihyperalgesic properties of the cholinesterase inhibitor physostigmine and the opioid alfentanil, alone and in combination, in an experimental pain model in humans... CONCLUSIONS: Physostigmine and alfentanil showed distinct effects on pain and hyperalgesia in a human pain model. The interaction of both drugs was found to be infra-additive.

more studies >>

Clinical Trials Related to Alfentanil

Optimal Dose of Alfentanil for Removal of Supreme Laryngeal Mask Airway During Emergence From Desflurane Anaesthesia [Recruiting]
This study aims to determine the optimal dose of alfentanil in suppressing the airway reflexes during supreme LMA removal in anaesthetized adult.

Stress During Deep Sedation With Propofol With and Without Alfentanil [Recruiting]
This is a randomized clinical trial of deep procedural sedation with propofol with and without supplemental alfentanil. Patients will be assessed for total and fractionated serum catecholamines before and after the procedure in addition to usual procedural sedation outcomes parameters to assess the adrenergic effect of propofol sedation without supplemental opioid.

Propofol Versus Alfentanil Versus Nitrous Oxide for Moderate Procedural Sedation [Recruiting]

Diamorphine or Alfentanil for Subcutaneous Use in Hospice In-patients? [Recruiting]
OBJECTIVES:

How does Alfentanil compare with the standard drug Diamorphine for subcutaneous analgesia in the palliative care setting?

STUDY DESIGN:

An open-label pilot comparison between alfentanil and diamorphine for palliative care patients who require subcutaneous opioids.

The Effect of an Opioid on the Lower Esophageal Sphincter During Anesthesia Induction [Recruiting]
During anesthesia induction and tracheal intubation one major concern is to avoid passive regurgitation of gastric content and aspiration.

The lower esophageal sphincter is a muscle located at the distal end of the esophagus. It plays an important role in creating a barrier between the stomach and the esophagus. The term "barrierpressure" is defined as the pressure difference between the lower esophageal sphincter pressure and the pressure in the stomach (intragastric pressure).

There are studies showing that opioids given iv/im, in the vein or in the muscle, may decrease the pressure in the lower esophageal sphincter and hereby increase the risk of aspiration.

Nevertheless,other studies shows that opioids are still frequently given to patients during anesthesia induction. This is done in order to prevent the cardiovascular response to (the painful) intubation which can often be seen as an equally high risk for the patient as the risk of aspiration.

In light of the above description, the investigators are planning a study in volunteers with the primary aim of investigating the effects of an opioid (alfentanil) on the pressures in the lower esophageal sphincter.

Another safety measure taken during anesthesia induction is the so called "cricoid pressure". This is based on the theory that passive regurgitation of gastric content may be prevented by occluding the esophagus by pressing on the cricoid cartilage. However, there are studies indicating that the application of cricoid pressure also may decrease the tonus of the lower esophageal sphincter.

The secondary aim of the study is to investigate the effect of cricoid pressure application on the pressure in the lower esophageal sphincter.

Measurements are being done using high-resolution solid-state manometry.

more trials >>

Reports of Suspected Alfentanil Side Effects

Anaphylactic Shock (7)Respiratory Depression (4)Fatigue (4)Maternal Exposure During Pregnancy (2)Toxic Epidermal Necrolysis (2)Maternal Drugs Affecting Foetus (1)Caesarean Section (1)Upper Airway Obstruction (1)Hepatitis Acute (1)


Page last updated: 2014-10-17

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