舒芬太尼
**舒芬太尼 (Sufentanil)** 是一種極效的合成鴉片類鎮痛藥（效力約為芬太尼的 5 至 10 倍，嗎啡的 500 至 1000 倍）。 在獸醫學中，主要用作**輔助麻醉劑**或**硬脊膜外鎮痛**。 關鍵臨床重點： * **效力：** 與許多其他麻醉劑相比，能提供深度的鎮痛效果及極佳的心血管穩定性。 * **起效與恢復：** 具有快速起效的特點（1-3 分鐘），且恢復時間比芬太尼更快。 * **風險：** 帶有顯著的劑量依賴性呼吸及中樞神經系統抑制風險，必須對病患進行持續監測。
作用機制: Sufentanil acts as a highly selective and potent **mu-opioid receptor (MOR)** agonist in the central nervous system. * Binding to the G-protein coupled mu-receptor → inhibits adenylate cyclase → decreases intracellular cAMP. * This leads to the opening of inward-rectifying potassium channels (causing hyperpolarization) and the closing of voltage-gated calcium channels. * Result → **decreased release of nociceptive neurotransmitters** (such as Substance P and glutamate), interrupting pain transmission pathways in the dorsal horn of the spinal cord and altering pain perception in the brain.
各物種劑量
- Acute pain relief in an emergency · 0.1-0.5 micrograms/kg IV ; constant rate infusion of 0.5-1 micrograms/kg/hour · IV · CRI
- As a pre-med · 3 micrograms/kg IV · IV · Single dose · As a combination for induction: Sufentanil 3 micrograms/kg IV first, then diazepam or midazolam 0.2-0.5 mg IV.
- For epidural analgesia · 0.7-1 micrograms/kg diluted to a volume of 0.26 mL/kg with sterile saline · Epidural · Single dose · 1-4 hours · Onset of action in 10-15 minutes.
- Acute pain relief in an emergency · 0.75-2 micrograms/kg IV ; constant rate infusion of 1-2 micrograms/kg/hour · IV · CRI
- For surgical pain · 5 micrograms/kg IV prior to a CRI. CRI (post-operative) of 0.1 micrograms/kg/hour · IV · CRI · 2-6 hours · Duration of effect: 2-6 hours.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Hypersensitivity to sufentanil or other opioids
不良反應
- Respiratory depression (dose-related)
- CNS depression
- Bradycardia
- Skeletal muscle rigidity
- Asystole (rare)
- Hypercarbia (rare)
- Hypersensitivity reactions (rare)
藥物相互作用
- Beta-adrenergic blockers · May increase bradycardia and hypotension
- Calcium-channel blockers · May increase bradycardia and hypotension
- CNS depressants (e.g., barbiturates) · Additive effects can occur, exacerbating CNS or respiratory depression
- Nitrous oxide · Can cause cardiovascular depression if used with high dose sufentanil
監測
- Anesthetic and/or analgesic efficacy
- Cardiac rate
- Respiratory rate
- Pulse oximetry or other methods to measure blood oxygenation
過量
In dogs, the LD50 of intravenous sufentanil is 10.1-19.5 mg/kg. **Clinical Signs of Severe Overdose:** * Apnea * Circulatory collapse * Pulmonary edema * Seizures * Cardiac arrest and death **Treatment:** Consists of a combination of supportive therapy (ventilation, cardiovascular support) and administration of an opiate antagonist such as **naloxone**. Although sufentanil has a fairly rapid half-life, multiple doses of naloxone may be necessary. > **Clinical Pearl:** Because of the drug's extreme potency, use a tuberculin syringe to measure dosages less than 1 mL, and employ a dosage calculation/measurement double-check system.
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。