Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice |
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| Authors: | Stefan Lundeberg James A Roelofse |
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| Institution: | 1. Department of Pediatric Anesthesia and Intensive Care, Pain Treatment Service, Astrid Lindgren Children’s Hospital, Stockholm, Sweden;2. Department of Sedation and Pain Control, University of the Western Cape, Bellville, Cape town, South Africa;3. Department of Sedation and Pain Control, University College London, London, UK |
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| Abstract: | Sufentanil is a potent synthetic opioid. Like other opioids, sufentanil creates a stable hemodynamic environment in cardiovascularly compromised pediatric patients. Clearance, expressed as per kilogram, is increased in children compared to adults. The P450 CYP3A4 enzyme is responsible for the major metabolic N‐dealkylation pathway. Enzyme activity is reduced in neonates but the maturation of sufentanil clearance is not described. The free active fraction is affected by age because of the reduced α1‐acid glycoprotein plasma concentrations in neonates. Intranasal administration of sufentanil is a possible option for premedication, procedural sedation and analgesia in children, as this option has been found to be safe and effective. Studies concerning the pharmacokinetics and dynamics of sufentanil administered as a bolus or continuous infusion in children are few. |
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| Keywords: | opioids sufentanil pediatric pharmacokinetics pharmacodynamics |
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