Der Anaesthesist
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Sedation and analgesia are commonly practised in critically ill patients. The drugs and techniques used vary widely, however. Many reports have emphasized that analgesia has to be the primary goal in every therapeutic intervention in critically ill patients. ⋯ In a dose range of 0.75-1.0 micrograms.kg bw-1.h-1 this drug can safely be given to patients undergoing controlled mechanical ventilation. Caution is necessary in hypovolaemic patients, in whom hypotension can occur if sufentanil is administered in the recommended dose. Sufentanil in a dose range between 0.25-0.35 micrograms.kg bw-1.h-1 is safe when given to patients during the weaning period.
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The intracranial hemodynamic and metabolic effects of 20 micrograms/kg sufentanil were studied in ten mongrel dogs. Anesthesia was maintained with 0.7 vol.% end-tidal isoflurane and 50% nitrous oxide in oxygen. Catheters were inserted into both femoral arteries and veins, the superior sagittal sinus, the left atrium, and the lateral cerebral ventricle for blood pressure measurement, arterial and sagittal sinus blood sampling, radioactive microsphere injections, and intracranial pressure (ICP) monitoring. ⋯ These data are in contrast to studies in dogs, where sufentanil produced non-dose-dependent increases in CBF and ICP. Our results are more consistent with studies in humans and rats where administration of sufentanil was associated with either no change or decreases in cerebral hemodynamics, metabolism, and ICP. We conclude that in dogs with normal intracranial physiology sufentanil decreases regional and global CBF in response to a decrease in cerebral metabolic demand without significantly affecting ICP.