Providing straightforward information pertaining to drugs, drug use & drug policy. The Grey Pages promotes drug-related literacy and advocates a system of viable and tolerant drug policies. This is my personal collection of commentaries, essays, tid-bits, and other such writings on everything ranging from drug use, drug policy and drug-myths, to drug-science, addiction, human behavior, and the workings of the human brain. I started this blog with a particular focus on opioids, and over the past year have found my interest gravitate toward the intriguing, ever-changing world of designer intoxicants (i.e. "research chemicals" or "designer drugs").

Saturday, February 5, 2011

Fentanyl & Sufentanil Via Spinal

Potent Fentanyl Analogue for Post-Operative Analgesia (Sufentanil)
Sufentanil is a potent opioid used in the anaesthsia setting which is an analogue of fentanyl with 5 to 10 X the potency of fentanyl.

A study was conducted comparing the efficacy of fentanyl VS sufentanil administered with bupivacaine by the intrathecal route for post op pain control. The cocktail was injected prior to surgery - The outcome was that sufentanil provided a much longer period of post op analgesia than fentanyl: with the average duration of the fentanyl being around 2.5 hours, and sufentanil being over 4 hours. A link for this study is at the bottom of this entry.

When injected directly to the CNS (spine/brain) such as in the case of intrathecal injection, opioids bypass the blood brain barrier, immediately gaining access to central receptor sites - This means that instead of the drug's potency being in direct relation to systemic availability, potency is directly correlated to lipophilicity.

Both fentanyl and sufentanil by this route travel within cerebrospinal fluid and make their way into the spinal cord; where they selectively bind to mu1 and mu2 opioid receptors in the dorsal horn, non specific opioid receptors in the white matter of the spine/CNS, and additionally travel the dura matter making their way into the epidural space where they bind to epidural fat tissue. As stated in part 1, this provides rapid onset with a brief and limited spread of the drug.

Both anaesthesia and analgesia by the spinal route is well tolerated and very effective in:

Labor-Child birth, C-Section birth, Hip replacement surgery, knee replacement, procedures on the lower leg and ankles, gynecological or urological surgeries and operations involving the abdominal area below the rib-cage.

Fenta/Sufenta Study

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