阿芬太尼

Alfentanil

Alfentanil Hydrochloride

鴉片類麻醉輔助劑 / 鴉片類鎮痛藥IVIMCRI狗貓

別名: Fanaxal · Fentalim · Limifen · Rapifen · alfentanyl · Alfentanilum

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

經審核的 v13 劑量證據

結構化劑量計算證據

Analgesia (extra-label) — Intraoperative analgesia in patients with intracranial disease

0.2 mcg/kg/mcg/kg/minIV

須由已驗證獸醫確認

必須同時考慮的臨床上下文 (3)

NOTE: In obese patients, calculate doses based on lean body weight.
Analgesia (extra-label):
Alfentanil injection should be stored protected from light at controlled room temperature (20°C-25°C; 68°F-77°F).

受管制藥物須由已驗證獸醫確認formulary方案年份 2023審核 dose-audit-plumb-v13

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

阿芬太尼是一種強效、短效的合成鴉片類藥物，屬於苯基哌啶類，結構上與芬太尼相似。

主要特徵包括：

起效快且作用時間短： 具高脂溶性，能迅速穿透血腦屏障，非常適合用於短時間的手術或作為連續速率輸注 (CRI)。
麻醉輔助劑： 主要用於提供深度的鎮痛效果，並減少誘導或維持麻醉劑（如丙泊酚、異氟醚）的所需劑量。
物種特異性： 雖然在獸醫學上的使用經驗不如芬太尼豐富，但特別指出在貓的麻醉過程中作為輔助治療非常有用。
管制狀態： 由於具有高度濫用潛力，被列為第二級管制藥品。

作用機制

Alfentanil acts primarily as a potent and highly selective agonist at mu (μ) opioid receptors in the central nervous system.

Mechanism: Binds to pre- and post-synaptic μ-receptors → inhibits adenylate cyclase → decreases intracellular cAMP → promotes opening of inward-rectifying potassium channels → hyperpolarization of the neuron.
Neurotransmitter Inhibition: Concurrently inhibits voltage-gated calcium channels → decreases the release of excitatory nociceptive neurotransmitters (such as substance P and glutamate) → profound analgesia and sedation.
Systemic Effects: Causes dose-dependent respiratory depression by decreasing the responsiveness of the brainstem respiratory centers to carbon dioxide.

安全性與警告

禁忌症

Patients hypersensitive to opioids

不良反應

Dose-related respiratory depression
Bradycardia
CNS depression
Dose-related skeletal muscle rigidity
Asystole (rare)
Hypercarbia (rare)
Hypersensitivity reactions (rare)

注意事項

Critical Warning: Because of the drug's potency and potential for significant adverse effects, it should only be used in situations where patient vital signs can be continuously monitored.

Dose Adjustments: Initial dosage reduction may be required in geriatric or debilitated patients, particularly those with diminished cardiopulmonary function or liver disease.
Muscle Rigidity: Dose-related skeletal muscle rigidity is not uncommon; neuromuscular blockers are routinely used in conjunction.
Laboratory Artifacts: May increase plasma levels of amylase or lipase secondary to increased biliary tract pressure. Values may be unreliable for 24 hours post-administration.

藥物相互作用

CYP3A4 Inhibitors (erythromycin, cimetidine, ketoconazole, itraconazole, fluconazole, diltiazem)

May increase the half-life and decrease the clearance of alfentanil leading to prolonged effect and an increased risk of respiratory depression

Beta-blockers

May produce bradycardia or hypotension if used concurrently with alfentanil

Other anesthetic agents

May produce bradycardia or hypotension; respiratory or CNS depression may be exacerbated

Inhaled anaestheticsMajor

Reduces the dose requirements of concurrently administered anaesthetics by at least 50%

Monoamine oxidase inhibitors (MAOIs)Major

Risk of serotonin toxicity

監測

Anesthetic and/or analgesic efficacy
Cardiac rate and rhythm
Respiratory rate and depth
Pulse oximetry or other methods to measure blood oxygenation

藥物動力學

半衰期

狗~20 minutes

吸收

In humans, onset of anesthetic action occurs within 2 minutes after IV dosing, and within 5 minutes of IM injection. Peak effects occur approximately 15 minutes after IM injection.

分佈

Steady state volume of distribution in dogs is about 0.56 L/kg. In humans, Vd is 0.4-1 L/kg. About 90% of the drug is bound to plasma proteins.

代謝

Primarily metabolized in the liver to inactive metabolites.

排除

Metabolites are excreted by the kidneys into the urine; only about 1% of the drug is excreted unchanged into the urine. Clearance in dogs is approximately 30 mL/kg/minute.

過量

Signs of Toxicity

Severe IV Overdose: Circulatory collapse, pulmonary edema, seizures, cardiac arrest, and death.
Less Severe Overdose: CNS and respiratory depression, coma, hypotension, muscle flaccidity, and miosis.

Treatment

Supportive Care: Provide cardiovascular and respiratory support (e.g., mechanical ventilation, IV fluids) as necessary.
Antidote: Administration of an opiate antagonist such as naloxone. Although alfentanil has a relatively rapid half-life, multiple doses of naloxone may be necessary.

Measurement Precaution: Because of the drug's extreme potency, the use of a tuberculin syringe to measure dosages less than 1 mL, along with a dosage calculation and measurement double-check system, is strongly recommended.

可用產品

劑型

Injection: 500 micrograms/mL

人用標示

Alfentanil HCl for injection: 500 micrograms (as base)/mL in 2, 5 mL, 10 mL, & 20 mL amps; preservative-free; Alfenta® (Akorn); generic (Abbott); (Rx, C-II)

各地核准狀態

European Union✓ 已核准處方藥 · Schedule 2EMA

Controlled Drug

United Kingdom✓ 已核准處方藥 · Schedule 2VMD

POM CD SCHEDULE 2

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Alfentanil injection should be stored protected from light at room temperature. Compatible with Normal Saline, D5 in Normal Saline, D5W, and Lactated Ringers in concentrations up to 80 micrograms/mL.

飼主須知

阿芬太尼是一種極強效的鴉片類藥物，嚴格用於麻醉和重度疼痛管理。

僅限專業使用： 此藥物僅由獸醫專業人員在具備進階生理監測（如心電圖和血氧監測）的臨床環境中施打。
安全性： 因為它可能會減緩呼吸和心跳，您的寵物在整個手術過程中將受到密切監控。
麻醉後狀態： 手術後您的寵物可能會感到昏昏欲睡或疲倦，這是鴉片類麻醉劑的正常反應。

VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。