Phentanyl PK/PD, a valid drug
Keywords:
fentanyl, pharmacokinetics, pharmacology, nomograms, intravenous anesthesia
Abstract
With the advent of the new opioids in the anesthetic drug market, we may think that we have molecules available to replace the legendary fentanyl. However, studying its pharmacodynamic and pharmacokinetic properties, fentanyl can still be appropriately used to take advantage of its excellent analgesia and safety, comparable to that of other opioids when administered in accordance with pharmacokinetic models.
We must not forget however that several drugs frequently used during anesthesia (midazolam, dexametasone, prednisolone, ketamin, etc.), may impact the metabolism of fentanyl on account of the cytochrome P450 3A4 enzyme.
The knowledge and judicious application of pharmacokinetic models serve to estimate plasma concentrations in order to ensure the best analgesic conditions associated to synergies with the frequent use of hypnotics such as propofol and desfluorane. fentanyl is best used for specific indications such as extended surgical procedures (over 120 minutes) or procedures that stimulate the patient´s pain perception.
References
1. Gutstein HB, Akil H. Opioid Analgesics. En Goodman & Gilman`s. The Pharmacological Basis of Therapeutics. 11th Ed. New York. McGraw Hill; 2006. p. 547-90.
2. Coda B. Opioids. En Barash PG. Clinical Anesthesia. Fifth edition. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 353-83.
3. Wang H, Li EY, Xu GW, Wang CS, Gong YL, Li P. Intravenous fentanyl is exhaled and the concentration fluctuates with time. J Int Med Res. 2009;37(4):1158-66.
4. Coral IS, Moore AR, Strunin L. Plasma concentrations of fentanyl in normal surgical patients with severe renal failure. Br J Anaesth. 1980; 52:101.
5. Fine, P, Portenoy, RK. Opioid analgesia, 2nd Edition. McGraw Hill, New York 2007.
6. Labroo RB, Paine MF, Thummel KE, Kharasch ED. fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implications for interindividual variability in disposition, efficacy, and drug interactions. Drug Metab Dispos. 1997;25(9):1072-80.
7. Stoeckel H, Hengstmann JH, Schüttler J. pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth. 1979; 51(8): 741-5.
8. Adams A, Pybus D. Delayed respiratory depression after use of fentanyl during anaesthesia. Br Med J. 1978; 1(6108): 278-9.
9. Williams JH. Delayed respiratory depression after use of fentanyl. Br Medical J. 1978; 1:441.
10. Shafer S, Varvel J. pharmacokinetics, Pharmacodynamics, and Rational Opioid Selection. Anesthesiology. 1991; 74 (1): 53-63.
11. Yassen A, Olofsen E, Romberg R, Sarton E, Teppema L, Danhof M et al. Mechanism-based PK/PD modeling of the respiratory depressant effect of buprenorphine and fentanyl in healthy volunteers. Clin Pharmacol Ther. 2007; 81(1):50-8.
12. Magosso E, Ursino M, van Oostrom JH. Opioid-induced respiratory depression: a mathematical model for fentanyl. IEEE Trans Biomed Eng. 2004;51(7):1115-28.
13. Sternlo JE, Sandin RH. Recurrent respiratory depression after total intravenous anaesthesia with propofol and alfentanil. Anaesthesia. 1998;53(4):378-81.
14. Krane BD, Kreutz JM, Johnson DL, Mazuzan JE Jr. Alfentanil and delayed respiratory depression: case studies and review. Anesth Analg. 1990;70(5):557-61.
15. Scholz J, Steinfath M, Schulz M. Clinical pharmacokinetics of alfentanil, fentanyl and sufentanil. An update. Clin Pharmacokinet. 1996;31(4):275-92.
16. Glass P, Jacobs J, Smith R, Ginsberg B, Quill T, Bai S et al. Pharmacokinetic Model-driven Infusion of fentanyl: Assesment of Accuracy. Anesthesiology. 1990; 73 (6): 1082-90.
17. Shafer S, Varvel J, Aziz N, Scott J. pharmacokinetics of fentanyl Administered by Computer - controlled Infusion Pump. Anesthesiology. 1990; 73 (6): 1091-1102.
18. Youngs E, Shafer S. Pharmacokinetic Parameters Relevant to Recovery from Opioids. Anesthesiology 1994; 81 (4): 833-42.
19. Scott JC, Stanski DR. Decreased fentanyl and alfentanil dose requirements with age. A simultaneous pharmacokinetic and pharmacodynamic evaluation. J Pharmacol Exp Ther. 1987;240(1):159-66.
20. Shibutani K, Inchiosa M, Sawada K, Bairamian M. Accuracy of Pharmacokinetic Models for Predicting Plasma fentanyl Concentrations in Lean and Obese Surgical Patients. Derivation of Dosing Weight ("Pharmacokinetic Mass"). Anesthesiology. 2004; 101(3): 603-13.
21. Vuyk J, Mertens M, Olofsen E, Burm A, Bovill J. Propofol Anesthesia and Rational Opioid Selection: Determination of Optimal EC sub 50 -EC sub 95 Propofol-Opioid Concentrations that Assure Adequate Anesthesia and a Rapid Return of Consciousness. Anesthesiology. 1997; 87 (6): 1549-62.
22. Smith C, McEwan A, Jhaveri R, Wilkinson M, Goodman D, Smith R et al. The Interaction of fentanyl onthe Cp50 of Propofol for Loss of Conciousness and Skin Incision. Anethesiology, 1994; 81(4):820-8.
23. Mildh LH, Scheinin H, Kirvelä OA. The concentration-effect relationship of the respiratory depressant effects of alfentanil and fentanyl. Anesth Analg. 2001;93(4):939-46.
24. Cartwright P, Prys-Roberts C, Gill K, Dye A, Stafford M, Gray A. Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans. Anesth Analg. 1983;62(11):966-74.
25. Kaneda K, Han TH. Comparative population pharmacokinetics of fentanyl using non-linear mixed effect modeling: burns vs. non-burns. Burns. 2009;35(6):790-7.
26. Koehntop DE, Rodman JH. fentanyl pharmacokinetics in patients undergoing renal transplantation. Pharmacotherapy 1997; 17:746-52.
27. Han T, Kim D, Kil H, Inagaki Y. The effects of plasma fentanyl concentrations on propofol requirement, emergence from anesthesia, and postoperative analgesia in propofol-nitrous oxide anesthesia. Anesth Analg. 2000;90(6):1365-71.
28. Iwakiri H, Nagata O, Matsukawa T, Ozaki M, Sessler D. Effect-Site Concentration of Propofol for Recovery of Consciousness Is Virtually Independent of fentanyl Effect-Site Concentration. Anesth Analg 2003;96:1651-55.
29. Ledowski T, Manopas A, Lauer S. Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl. Eur J Anaesthesiol. 2008;25(9):752-5.
30. Feld J, Hoffman W, Paisansathan C, Park H, Ananda RC. Autonomic activity during dexmedetomidine or fentanyl infusion with desflurane anesthesia. J Clin Anesth 2007; 19(1): 30-6.
31. Watcha M, White P. Postoperative Nausea and Vomiting Its Etiology, Treatment and Prevention. Anesthesiology 1992; 77 (1):162-84.
32. Yang H, Choi P, McChesney, Buckley N. Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery. Can J Anesth 2004; 51(7): 660-7.
33. Phitayakorn P, Melnick BM, Vicine AF 3rd. Comparison of sufentanil and fentanyl infusions for outpatient anaesthesia. Can J Anaesth. 1987; 34: 242-5.
34. Flacke JW, Bloor BC, Kripke BJ,Flacke WE, Warneck CM, Van Etten AP, Comparison of morphine, meperidine, fentanyl and sufentanil in balanced anesthesia: a double blind study. Anesth Analg. 1985; 64: 897-910.
35. Schuttler J, Albrecht S, Breivik H, Osnes S, Prys-Roberts C, Holder K, A comparison of remifentanil and alfentanil in patients undergoing major abdominal surgery. Anaesthesia. 1997; 52: 307-17.
36. Jellish WS, Leonetti JP, Avramov A, Fluder E, Murdoch J. Remifentanil-based anesthesia versus a propofol technique for otologic surgical procedure. Otolaryngol Head Neck Surg. 2000; 122: 222-7.
37. Michalowski P, DershwitzM, Rosow CE, Conlay LA, Chang YC. Total intravenous anesthesia with remifentanil or alfentanil in ambulatory orthopedic surgery carries minimal risk of postoperative nausea and vomiting. Anesthesiology. 1998; 89 (3A): A34.
38. Davis PJ, Finkel JC, Orr RJ. Fazi L, Mulroy JJ, Woelfel SK. A randomised, doble-blind study of remifentanil versus fentanyl for tonsillectomy and adenoidectomy surgery in pediatric ambulatory surgical patients. Anesth Analg 2000; 90: 863-71.
39. Gaszynski T, Strzelczyk J, Gaszynski W. Post-anesthesia Recovery after Infusion of Propofol with Remifentanil or Alfentanil or fentanyl in Morbidly Obese Patients. Obes Surg. 2004; 14: 498-504.
40. Langevin S, Lessard MR, Trépanier CA, Baribault JP. Alfentanil causes less postoperative nausea and vomiting than equipotent doses of fentanyl or sufentanil in outpatients. Anesthesiology. 1999;91(6):1666-73.
41. Bloomfield EL. The incidence of postoperative nausea and vomiting: a retrospective comparison of alfentanil versus sufentanil. Mil Med. 1992;157(2):59-61.
42. Rama-Maceiras P, Ferreira T, Molins N, Sanduende Y, Bautista A, Rey T. Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiol Scand. 2005; 49: 305-11.
43. Bowdle A. Adverse Effects of Opioid Agonists and Agonist-Antagonists in Anaesthesia. Drug Saf. 1998; 19 (3): 173-89.
44. Streisand J, Bailey P, LeMaire L, Ashburn M, Tarver S, Varvel J et al. fentanyl-induced rigidity and Unconsciousness in Human Volunteers. Incidence, Duration and Plasma Concentrations. Anesthesiology 1993; 78(4): 629-34.
45. Bowdle T, Rooke G. Postoperative Myoclonus and Rigidity After Anesthesia with Opioids. Anesth Analg 1994;78:783-6.
46. Roy S, Fortier L. fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine La rigidité induite par le fentanyl, pendant le retour à la conscience qui suit l´anesthésie générale, est potentialisée par la venlafexine.Can J Anesth. 2003; 50(1): 32-5.
47. Smith NT, Benthuysen JL, Bickford RG, Sanford TJ, Blasco T, Duke PC, Seizures during opioid anesthetic induction-are they opioid-induced rigidity? Anesthesiology 1989;71:85242.
48. Fahnenstich H, Steffan J, Kau N, Bartmann P. fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants. Crit Care Med. 2000; 28 (3): 836-9.
49. Bailey P, Wilbrink J, Zwanikken P, Pace N, Stanley T. Anesthetic Induction with fentanyl. Anesth Analg. 1985; 64: 48-53.
50. Lui PW. Involvement of spinal adenosine A1 and A2 receptors in fentanyl-induced muscular rigidity in the rat. Neurosci Lett. 1997; 224(3): 189-92.
1. Gutstein HB, Akil H. Opioid Analgesics. En Goodman & Gilman`s. The Pharmacological Basis of Therapeutics. 11th Ed. New York. McGraw Hill; 2006. p. 547-90.
2. Coda B. Opioids. En Barash PG. Clinical Anesthesia. Fifth edition. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 353-83.
3. Wang H, Li EY, Xu GW, Wang CS, Gong YL, Li P. Intravenous fentanyl is exhaled and the concentration fluctuates with time. J Int Med Res. 2009;37(4):1158-66.
4. Coral IS, Moore AR, Strunin L. Plasma concentrations of fentanyl in normal surgical patients with severe renal failure. Br J Anaesth. 1980; 52:101.
5. Fine, P, Portenoy, RK. Opioid analgesia, 2nd Edition. McGraw Hill, New York 2007.
6. Labroo RB, Paine MF, Thummel KE, Kharasch ED. Fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implications for interindividual variability in disposition, efficacy, and drug interactions. Drug Metab Dispos. 1997;25(9):1072-80.
7. Stoeckel H, Hengstmann JH, Schüttler J. Pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth. 1979; 51(8): 741-5.
8. Adams A, Pybus D. Delayed respiratory depression after use of fentanyl during anaesthesia. Br Med J. 1978; 1(6108): 278-9.
9. Williams JH. Delayed respiratory depression after use of fentanyl. Br Medical J. 1978; 1:441.
10. Shafer S, Varvel J. Pharmacokinetics, Pharmacodynamics, and Rational Opioid Selection. Anesthesiology. 1991; 74 (1): 53-63.
11. Yassen A, Olofsen E, Romberg R, Sarton E, Teppema L, Danhof M et al. Mechanism-based PK/PD modeling of the respiratory depressant effect of buprenorphine and fentanyl in healthy volunteers. Clin Pharmacol Ther. 2007; 81(1):50-8.
12. Magosso E, Ursino M, van Oostrom JH. Opioid-induced respiratory depression: a mathematical model for fentanyl. IEEE Trans Biomed Eng. 2004;51(7):1115-28.
13. Sternlo JE, Sandin RH. Recurrent respiratory depression after total intravenous anaesthesia with propofol and alfentanil. Anaesthesia. 1998;53(4):378-81.
14. Krane BD, Kreutz JM, Johnson DL, Mazuzan JE Jr. Alfentanil and delayed respiratory depression: case studies and review. Anesth Analg. 1990;70(5):557-61.
15. Scholz J, Steinfath M, Schulz M. Clinical pharmacokinetics of alfentanil, fentanyl and sufentanil. An update. Clin Pharmacokinet. 1996;31(4):275-92.
16. Glass P, Jacobs J, Smith R, Ginsberg B, Quill T, Bai S et al. Pharmacokinetic Model-driven Infusion of Fentanyl: Assesment of Accuracy. Anesthesiology. 1990; 73 (6): 1082-90.
17. Shafer S, Varvel J, Aziz N, Scott J. Pharmacokinetics of Fentanyl Administered by Computer - controlled Infusion Pump. Anesthesiology. 1990; 73 (6): 1091-1102.
18. Youngs E, Shafer S. Pharmacokinetic Parameters Relevant to Recovery from Opioids. Anesthesiology 1994; 81 (4): 833-42.
19. Scott JC, Stanski DR. Decreased fentanyl and alfentanil dose requirements with age. A simultaneous pharmacokinetic and pharmacodynamic evaluation. J Pharmacol Exp Ther. 1987;240(1):159-66.
20. Shibutani K, Inchiosa M, Sawada K, Bairamian M. Accuracy of Pharmacokinetic Models for Predicting Plasma Fentanyl Concentrations in Lean and Obese Surgical Patients. Derivation of Dosing Weight ("Pharmacokinetic Mass"). Anesthesiology. 2004; 101(3): 603-13.
21. Vuyk J, Mertens M, Olofsen E, Burm A, Bovill J. Propofol Anesthesia and Rational Opioid Selection: Determination of Optimal EC sub 50 -EC sub 95 Propofol-Opioid Concentrations that Assure Adequate Anesthesia and a Rapid Return of Consciousness. Anesthesiology. 1997; 87 (6): 1549-62.
22. Smith C, McEwan A, Jhaveri R, Wilkinson M, Goodman D, Smith R et al. The Interaction of Fentanyl onthe Cp50 of Propofol for Loss of Conciousness and Skin Incision. Anethesiology, 1994; 81(4):820-8.
23. Mildh LH, Scheinin H, Kirvelä OA. The concentration-effect relationship of the respiratory depressant effects of alfentanil and fentanyl. Anesth Analg. 2001;93(4):939-46.
24. Cartwright P, Prys-Roberts C, Gill K, Dye A, Stafford M, Gray A. Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans. Anesth Analg. 1983;62(11):966-74.
25. Kaneda K, Han TH. Comparative population pharmacokinetics of fentanyl using non-linear mixed effect modeling: burns vs. non-burns. Burns. 2009;35(6):790-7.
26. Koehntop DE, Rodman JH. Fentanyl pharmacokinetics in patients undergoing renal transplantation. Pharmacotherapy 1997; 17:746-52.
27. Han T, Kim D, Kil H, Inagaki Y. The effects of plasma fentanyl concentrations on propofol requirement, emergence from anesthesia, and postoperative analgesia in propofol-nitrous oxide anesthesia. Anesth Analg. 2000;90(6):1365-71.
28. Iwakiri H, Nagata O, Matsukawa T, Ozaki M, Sessler D. Effect-Site Concentration of Propofol for Recovery of Consciousness Is Virtually Independent of Fentanyl Effect-Site Concentration. Anesth Analg 2003;96:1651-55.
29. Ledowski T, Manopas A, Lauer S. Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl. Eur J Anaesthesiol. 2008;25(9):752-5.
30. Feld J, Hoffman W, Paisansathan C, Park H, Ananda RC. Autonomic activity during dexmedetomidine or fentanyl infusion with desflurane anesthesia. J Clin Anesth 2007; 19(1): 30-6.
31. Watcha M, White P. Postoperative Nausea and Vomiting Its Etiology, Treatment and Prevention. Anesthesiology 1992; 77 (1):162-84.
32. Yang H, Choi P, McChesney, Buckley N. Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery. Can J Anesth 2004; 51(7): 660-7.
33. Phitayakorn P, Melnick BM, Vicine AF 3rd. Comparison of sufentanil and fentanyl infusions for outpatient anaesthesia. Can J Anaesth. 1987; 34: 242-5.
34. Flacke JW, Bloor BC, Kripke BJ,Flacke WE, Warneck CM, Van Etten AP, Comparison of morphine, meperidine, fentanyl and sufentanil in balanced anesthesia: a double blind study. Anesth Analg. 1985; 64: 897-910.
35. Schuttler J, Albrecht S, Breivik H, Osnes S, Prys-Roberts C, Holder K, A comparison of remifentanil and alfentanil in patients undergoing major abdominal surgery. Anaesthesia. 1997; 52: 307-17.
36. Jellish WS, Leonetti JP, Avramov A, Fluder E, Murdoch J. Remifentanil-based anesthesia versus a propofol technique for otologic surgical procedure. Otolaryngol Head Neck Surg. 2000; 122: 222-7.
37. Michalowski P, DershwitzM, Rosow CE, Conlay LA, Chang YC. Total intravenous anesthesia with remifentanil or alfentanil in ambulatory orthopedic surgery carries minimal risk of postoperative nausea and vomiting. Anesthesiology. 1998; 89 (3A): A34.
38. Davis PJ, Finkel JC, Orr RJ. Fazi L, Mulroy JJ, Woelfel SK. A randomised, doble-blind study of remifentanil versus fentanyl for tonsillectomy and adenoidectomy surgery in pediatric ambulatory surgical patients. Anesth Analg 2000; 90: 863-71.
39. Gaszynski T, Strzelczyk J, Gaszynski W. Post-anesthesia Recovery after Infusion of Propofol with Remifentanil or Alfentanil or Fentanyl in Morbidly Obese Patients. Obes Surg. 2004; 14: 498-504.
40. Langevin S, Lessard MR, Trépanier CA, Baribault JP. Alfentanil causes less postoperative nausea and vomiting than equipotent doses of fentanyl or sufentanil in outpatients. Anesthesiology. 1999;91(6):1666-73.
41. Bloomfield EL. The incidence of postoperative nausea and vomiting: a retrospective comparison of alfentanil versus sufentanil. Mil Med. 1992;157(2):59-61.
42. Rama-Maceiras P, Ferreira T, Molins N, Sanduende Y, Bautista A, Rey T. Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiol Scand. 2005; 49: 305-11.
43. Bowdle A. Adverse Effects of Opioid Agonists and Agonist-Antagonists in Anaesthesia. Drug Saf. 1998; 19 (3): 173-89.
44. Streisand J, Bailey P, LeMaire L, Ashburn M, Tarver S, Varvel J et al. Fentanyl-induced rigidity and Unconsciousness in Human Volunteers. Incidence, Duration and Plasma Concentrations. Anesthesiology 1993; 78(4): 629-34.
45. Bowdle T, Rooke G. Postoperative Myoclonus and Rigidity After Anesthesia with Opioids. Anesth Analg 1994;78:783-6.
46. Roy S, Fortier L. Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine La rigidité induite par le fentanyl, pendant le retour à la conscience qui suit l´anesthésie générale, est potentialisée par la venlafexine.Can J Anesth. 2003; 50(1): 32-5.
47. Smith NT, Benthuysen JL, Bickford RG, Sanford TJ, Blasco T, Duke PC, Seizures during opioid anesthetic induction-are they opioid-induced rigidity? Anesthesiology 1989;71:85242.
48. Fahnenstich H, Steffan J, Kau N, Bartmann P. Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants. Crit Care Med. 2000; 28 (3): 836-9.
49. Bailey P, Wilbrink J, Zwanikken P, Pace N, Stanley T. Anesthetic Induction with Fentanyl. Anesth Analg. 1985; 64: 48-53.
50. Lui PW. Involvement of spinal adenosine A1 and A2 receptors in fentanyl-induced muscular rigidity in the rat. Neurosci Lett. 1997; 224(3): 189-92.
2. Coda B. Opioids. En Barash PG. Clinical Anesthesia. Fifth edition. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 353-83.
3. Wang H, Li EY, Xu GW, Wang CS, Gong YL, Li P. Intravenous fentanyl is exhaled and the concentration fluctuates with time. J Int Med Res. 2009;37(4):1158-66.
4. Coral IS, Moore AR, Strunin L. Plasma concentrations of fentanyl in normal surgical patients with severe renal failure. Br J Anaesth. 1980; 52:101.
5. Fine, P, Portenoy, RK. Opioid analgesia, 2nd Edition. McGraw Hill, New York 2007.
6. Labroo RB, Paine MF, Thummel KE, Kharasch ED. fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implications for interindividual variability in disposition, efficacy, and drug interactions. Drug Metab Dispos. 1997;25(9):1072-80.
7. Stoeckel H, Hengstmann JH, Schüttler J. pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth. 1979; 51(8): 741-5.
8. Adams A, Pybus D. Delayed respiratory depression after use of fentanyl during anaesthesia. Br Med J. 1978; 1(6108): 278-9.
9. Williams JH. Delayed respiratory depression after use of fentanyl. Br Medical J. 1978; 1:441.
10. Shafer S, Varvel J. pharmacokinetics, Pharmacodynamics, and Rational Opioid Selection. Anesthesiology. 1991; 74 (1): 53-63.
11. Yassen A, Olofsen E, Romberg R, Sarton E, Teppema L, Danhof M et al. Mechanism-based PK/PD modeling of the respiratory depressant effect of buprenorphine and fentanyl in healthy volunteers. Clin Pharmacol Ther. 2007; 81(1):50-8.
12. Magosso E, Ursino M, van Oostrom JH. Opioid-induced respiratory depression: a mathematical model for fentanyl. IEEE Trans Biomed Eng. 2004;51(7):1115-28.
13. Sternlo JE, Sandin RH. Recurrent respiratory depression after total intravenous anaesthesia with propofol and alfentanil. Anaesthesia. 1998;53(4):378-81.
14. Krane BD, Kreutz JM, Johnson DL, Mazuzan JE Jr. Alfentanil and delayed respiratory depression: case studies and review. Anesth Analg. 1990;70(5):557-61.
15. Scholz J, Steinfath M, Schulz M. Clinical pharmacokinetics of alfentanil, fentanyl and sufentanil. An update. Clin Pharmacokinet. 1996;31(4):275-92.
16. Glass P, Jacobs J, Smith R, Ginsberg B, Quill T, Bai S et al. Pharmacokinetic Model-driven Infusion of fentanyl: Assesment of Accuracy. Anesthesiology. 1990; 73 (6): 1082-90.
17. Shafer S, Varvel J, Aziz N, Scott J. pharmacokinetics of fentanyl Administered by Computer - controlled Infusion Pump. Anesthesiology. 1990; 73 (6): 1091-1102.
18. Youngs E, Shafer S. Pharmacokinetic Parameters Relevant to Recovery from Opioids. Anesthesiology 1994; 81 (4): 833-42.
19. Scott JC, Stanski DR. Decreased fentanyl and alfentanil dose requirements with age. A simultaneous pharmacokinetic and pharmacodynamic evaluation. J Pharmacol Exp Ther. 1987;240(1):159-66.
20. Shibutani K, Inchiosa M, Sawada K, Bairamian M. Accuracy of Pharmacokinetic Models for Predicting Plasma fentanyl Concentrations in Lean and Obese Surgical Patients. Derivation of Dosing Weight ("Pharmacokinetic Mass"). Anesthesiology. 2004; 101(3): 603-13.
21. Vuyk J, Mertens M, Olofsen E, Burm A, Bovill J. Propofol Anesthesia and Rational Opioid Selection: Determination of Optimal EC sub 50 -EC sub 95 Propofol-Opioid Concentrations that Assure Adequate Anesthesia and a Rapid Return of Consciousness. Anesthesiology. 1997; 87 (6): 1549-62.
22. Smith C, McEwan A, Jhaveri R, Wilkinson M, Goodman D, Smith R et al. The Interaction of fentanyl onthe Cp50 of Propofol for Loss of Conciousness and Skin Incision. Anethesiology, 1994; 81(4):820-8.
23. Mildh LH, Scheinin H, Kirvelä OA. The concentration-effect relationship of the respiratory depressant effects of alfentanil and fentanyl. Anesth Analg. 2001;93(4):939-46.
24. Cartwright P, Prys-Roberts C, Gill K, Dye A, Stafford M, Gray A. Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans. Anesth Analg. 1983;62(11):966-74.
25. Kaneda K, Han TH. Comparative population pharmacokinetics of fentanyl using non-linear mixed effect modeling: burns vs. non-burns. Burns. 2009;35(6):790-7.
26. Koehntop DE, Rodman JH. fentanyl pharmacokinetics in patients undergoing renal transplantation. Pharmacotherapy 1997; 17:746-52.
27. Han T, Kim D, Kil H, Inagaki Y. The effects of plasma fentanyl concentrations on propofol requirement, emergence from anesthesia, and postoperative analgesia in propofol-nitrous oxide anesthesia. Anesth Analg. 2000;90(6):1365-71.
28. Iwakiri H, Nagata O, Matsukawa T, Ozaki M, Sessler D. Effect-Site Concentration of Propofol for Recovery of Consciousness Is Virtually Independent of fentanyl Effect-Site Concentration. Anesth Analg 2003;96:1651-55.
29. Ledowski T, Manopas A, Lauer S. Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl. Eur J Anaesthesiol. 2008;25(9):752-5.
30. Feld J, Hoffman W, Paisansathan C, Park H, Ananda RC. Autonomic activity during dexmedetomidine or fentanyl infusion with desflurane anesthesia. J Clin Anesth 2007; 19(1): 30-6.
31. Watcha M, White P. Postoperative Nausea and Vomiting Its Etiology, Treatment and Prevention. Anesthesiology 1992; 77 (1):162-84.
32. Yang H, Choi P, McChesney, Buckley N. Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery. Can J Anesth 2004; 51(7): 660-7.
33. Phitayakorn P, Melnick BM, Vicine AF 3rd. Comparison of sufentanil and fentanyl infusions for outpatient anaesthesia. Can J Anaesth. 1987; 34: 242-5.
34. Flacke JW, Bloor BC, Kripke BJ,Flacke WE, Warneck CM, Van Etten AP, Comparison of morphine, meperidine, fentanyl and sufentanil in balanced anesthesia: a double blind study. Anesth Analg. 1985; 64: 897-910.
35. Schuttler J, Albrecht S, Breivik H, Osnes S, Prys-Roberts C, Holder K, A comparison of remifentanil and alfentanil in patients undergoing major abdominal surgery. Anaesthesia. 1997; 52: 307-17.
36. Jellish WS, Leonetti JP, Avramov A, Fluder E, Murdoch J. Remifentanil-based anesthesia versus a propofol technique for otologic surgical procedure. Otolaryngol Head Neck Surg. 2000; 122: 222-7.
37. Michalowski P, DershwitzM, Rosow CE, Conlay LA, Chang YC. Total intravenous anesthesia with remifentanil or alfentanil in ambulatory orthopedic surgery carries minimal risk of postoperative nausea and vomiting. Anesthesiology. 1998; 89 (3A): A34.
38. Davis PJ, Finkel JC, Orr RJ. Fazi L, Mulroy JJ, Woelfel SK. A randomised, doble-blind study of remifentanil versus fentanyl for tonsillectomy and adenoidectomy surgery in pediatric ambulatory surgical patients. Anesth Analg 2000; 90: 863-71.
39. Gaszynski T, Strzelczyk J, Gaszynski W. Post-anesthesia Recovery after Infusion of Propofol with Remifentanil or Alfentanil or fentanyl in Morbidly Obese Patients. Obes Surg. 2004; 14: 498-504.
40. Langevin S, Lessard MR, Trépanier CA, Baribault JP. Alfentanil causes less postoperative nausea and vomiting than equipotent doses of fentanyl or sufentanil in outpatients. Anesthesiology. 1999;91(6):1666-73.
41. Bloomfield EL. The incidence of postoperative nausea and vomiting: a retrospective comparison of alfentanil versus sufentanil. Mil Med. 1992;157(2):59-61.
42. Rama-Maceiras P, Ferreira T, Molins N, Sanduende Y, Bautista A, Rey T. Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiol Scand. 2005; 49: 305-11.
43. Bowdle A. Adverse Effects of Opioid Agonists and Agonist-Antagonists in Anaesthesia. Drug Saf. 1998; 19 (3): 173-89.
44. Streisand J, Bailey P, LeMaire L, Ashburn M, Tarver S, Varvel J et al. fentanyl-induced rigidity and Unconsciousness in Human Volunteers. Incidence, Duration and Plasma Concentrations. Anesthesiology 1993; 78(4): 629-34.
45. Bowdle T, Rooke G. Postoperative Myoclonus and Rigidity After Anesthesia with Opioids. Anesth Analg 1994;78:783-6.
46. Roy S, Fortier L. fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine La rigidité induite par le fentanyl, pendant le retour à la conscience qui suit l´anesthésie générale, est potentialisée par la venlafexine.Can J Anesth. 2003; 50(1): 32-5.
47. Smith NT, Benthuysen JL, Bickford RG, Sanford TJ, Blasco T, Duke PC, Seizures during opioid anesthetic induction-are they opioid-induced rigidity? Anesthesiology 1989;71:85242.
48. Fahnenstich H, Steffan J, Kau N, Bartmann P. fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants. Crit Care Med. 2000; 28 (3): 836-9.
49. Bailey P, Wilbrink J, Zwanikken P, Pace N, Stanley T. Anesthetic Induction with fentanyl. Anesth Analg. 1985; 64: 48-53.
50. Lui PW. Involvement of spinal adenosine A1 and A2 receptors in fentanyl-induced muscular rigidity in the rat. Neurosci Lett. 1997; 224(3): 189-92.
1. Gutstein HB, Akil H. Opioid Analgesics. En Goodman & Gilman`s. The Pharmacological Basis of Therapeutics. 11th Ed. New York. McGraw Hill; 2006. p. 547-90.
2. Coda B. Opioids. En Barash PG. Clinical Anesthesia. Fifth edition. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 353-83.
3. Wang H, Li EY, Xu GW, Wang CS, Gong YL, Li P. Intravenous fentanyl is exhaled and the concentration fluctuates with time. J Int Med Res. 2009;37(4):1158-66.
4. Coral IS, Moore AR, Strunin L. Plasma concentrations of fentanyl in normal surgical patients with severe renal failure. Br J Anaesth. 1980; 52:101.
5. Fine, P, Portenoy, RK. Opioid analgesia, 2nd Edition. McGraw Hill, New York 2007.
6. Labroo RB, Paine MF, Thummel KE, Kharasch ED. Fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implications for interindividual variability in disposition, efficacy, and drug interactions. Drug Metab Dispos. 1997;25(9):1072-80.
7. Stoeckel H, Hengstmann JH, Schüttler J. Pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth. 1979; 51(8): 741-5.
8. Adams A, Pybus D. Delayed respiratory depression after use of fentanyl during anaesthesia. Br Med J. 1978; 1(6108): 278-9.
9. Williams JH. Delayed respiratory depression after use of fentanyl. Br Medical J. 1978; 1:441.
10. Shafer S, Varvel J. Pharmacokinetics, Pharmacodynamics, and Rational Opioid Selection. Anesthesiology. 1991; 74 (1): 53-63.
11. Yassen A, Olofsen E, Romberg R, Sarton E, Teppema L, Danhof M et al. Mechanism-based PK/PD modeling of the respiratory depressant effect of buprenorphine and fentanyl in healthy volunteers. Clin Pharmacol Ther. 2007; 81(1):50-8.
12. Magosso E, Ursino M, van Oostrom JH. Opioid-induced respiratory depression: a mathematical model for fentanyl. IEEE Trans Biomed Eng. 2004;51(7):1115-28.
13. Sternlo JE, Sandin RH. Recurrent respiratory depression after total intravenous anaesthesia with propofol and alfentanil. Anaesthesia. 1998;53(4):378-81.
14. Krane BD, Kreutz JM, Johnson DL, Mazuzan JE Jr. Alfentanil and delayed respiratory depression: case studies and review. Anesth Analg. 1990;70(5):557-61.
15. Scholz J, Steinfath M, Schulz M. Clinical pharmacokinetics of alfentanil, fentanyl and sufentanil. An update. Clin Pharmacokinet. 1996;31(4):275-92.
16. Glass P, Jacobs J, Smith R, Ginsberg B, Quill T, Bai S et al. Pharmacokinetic Model-driven Infusion of Fentanyl: Assesment of Accuracy. Anesthesiology. 1990; 73 (6): 1082-90.
17. Shafer S, Varvel J, Aziz N, Scott J. Pharmacokinetics of Fentanyl Administered by Computer - controlled Infusion Pump. Anesthesiology. 1990; 73 (6): 1091-1102.
18. Youngs E, Shafer S. Pharmacokinetic Parameters Relevant to Recovery from Opioids. Anesthesiology 1994; 81 (4): 833-42.
19. Scott JC, Stanski DR. Decreased fentanyl and alfentanil dose requirements with age. A simultaneous pharmacokinetic and pharmacodynamic evaluation. J Pharmacol Exp Ther. 1987;240(1):159-66.
20. Shibutani K, Inchiosa M, Sawada K, Bairamian M. Accuracy of Pharmacokinetic Models for Predicting Plasma Fentanyl Concentrations in Lean and Obese Surgical Patients. Derivation of Dosing Weight ("Pharmacokinetic Mass"). Anesthesiology. 2004; 101(3): 603-13.
21. Vuyk J, Mertens M, Olofsen E, Burm A, Bovill J. Propofol Anesthesia and Rational Opioid Selection: Determination of Optimal EC sub 50 -EC sub 95 Propofol-Opioid Concentrations that Assure Adequate Anesthesia and a Rapid Return of Consciousness. Anesthesiology. 1997; 87 (6): 1549-62.
22. Smith C, McEwan A, Jhaveri R, Wilkinson M, Goodman D, Smith R et al. The Interaction of Fentanyl onthe Cp50 of Propofol for Loss of Conciousness and Skin Incision. Anethesiology, 1994; 81(4):820-8.
23. Mildh LH, Scheinin H, Kirvelä OA. The concentration-effect relationship of the respiratory depressant effects of alfentanil and fentanyl. Anesth Analg. 2001;93(4):939-46.
24. Cartwright P, Prys-Roberts C, Gill K, Dye A, Stafford M, Gray A. Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans. Anesth Analg. 1983;62(11):966-74.
25. Kaneda K, Han TH. Comparative population pharmacokinetics of fentanyl using non-linear mixed effect modeling: burns vs. non-burns. Burns. 2009;35(6):790-7.
26. Koehntop DE, Rodman JH. Fentanyl pharmacokinetics in patients undergoing renal transplantation. Pharmacotherapy 1997; 17:746-52.
27. Han T, Kim D, Kil H, Inagaki Y. The effects of plasma fentanyl concentrations on propofol requirement, emergence from anesthesia, and postoperative analgesia in propofol-nitrous oxide anesthesia. Anesth Analg. 2000;90(6):1365-71.
28. Iwakiri H, Nagata O, Matsukawa T, Ozaki M, Sessler D. Effect-Site Concentration of Propofol for Recovery of Consciousness Is Virtually Independent of Fentanyl Effect-Site Concentration. Anesth Analg 2003;96:1651-55.
29. Ledowski T, Manopas A, Lauer S. Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl. Eur J Anaesthesiol. 2008;25(9):752-5.
30. Feld J, Hoffman W, Paisansathan C, Park H, Ananda RC. Autonomic activity during dexmedetomidine or fentanyl infusion with desflurane anesthesia. J Clin Anesth 2007; 19(1): 30-6.
31. Watcha M, White P. Postoperative Nausea and Vomiting Its Etiology, Treatment and Prevention. Anesthesiology 1992; 77 (1):162-84.
32. Yang H, Choi P, McChesney, Buckley N. Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery. Can J Anesth 2004; 51(7): 660-7.
33. Phitayakorn P, Melnick BM, Vicine AF 3rd. Comparison of sufentanil and fentanyl infusions for outpatient anaesthesia. Can J Anaesth. 1987; 34: 242-5.
34. Flacke JW, Bloor BC, Kripke BJ,Flacke WE, Warneck CM, Van Etten AP, Comparison of morphine, meperidine, fentanyl and sufentanil in balanced anesthesia: a double blind study. Anesth Analg. 1985; 64: 897-910.
35. Schuttler J, Albrecht S, Breivik H, Osnes S, Prys-Roberts C, Holder K, A comparison of remifentanil and alfentanil in patients undergoing major abdominal surgery. Anaesthesia. 1997; 52: 307-17.
36. Jellish WS, Leonetti JP, Avramov A, Fluder E, Murdoch J. Remifentanil-based anesthesia versus a propofol technique for otologic surgical procedure. Otolaryngol Head Neck Surg. 2000; 122: 222-7.
37. Michalowski P, DershwitzM, Rosow CE, Conlay LA, Chang YC. Total intravenous anesthesia with remifentanil or alfentanil in ambulatory orthopedic surgery carries minimal risk of postoperative nausea and vomiting. Anesthesiology. 1998; 89 (3A): A34.
38. Davis PJ, Finkel JC, Orr RJ. Fazi L, Mulroy JJ, Woelfel SK. A randomised, doble-blind study of remifentanil versus fentanyl for tonsillectomy and adenoidectomy surgery in pediatric ambulatory surgical patients. Anesth Analg 2000; 90: 863-71.
39. Gaszynski T, Strzelczyk J, Gaszynski W. Post-anesthesia Recovery after Infusion of Propofol with Remifentanil or Alfentanil or Fentanyl in Morbidly Obese Patients. Obes Surg. 2004; 14: 498-504.
40. Langevin S, Lessard MR, Trépanier CA, Baribault JP. Alfentanil causes less postoperative nausea and vomiting than equipotent doses of fentanyl or sufentanil in outpatients. Anesthesiology. 1999;91(6):1666-73.
41. Bloomfield EL. The incidence of postoperative nausea and vomiting: a retrospective comparison of alfentanil versus sufentanil. Mil Med. 1992;157(2):59-61.
42. Rama-Maceiras P, Ferreira T, Molins N, Sanduende Y, Bautista A, Rey T. Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiol Scand. 2005; 49: 305-11.
43. Bowdle A. Adverse Effects of Opioid Agonists and Agonist-Antagonists in Anaesthesia. Drug Saf. 1998; 19 (3): 173-89.
44. Streisand J, Bailey P, LeMaire L, Ashburn M, Tarver S, Varvel J et al. Fentanyl-induced rigidity and Unconsciousness in Human Volunteers. Incidence, Duration and Plasma Concentrations. Anesthesiology 1993; 78(4): 629-34.
45. Bowdle T, Rooke G. Postoperative Myoclonus and Rigidity After Anesthesia with Opioids. Anesth Analg 1994;78:783-6.
46. Roy S, Fortier L. Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine La rigidité induite par le fentanyl, pendant le retour à la conscience qui suit l´anesthésie générale, est potentialisée par la venlafexine.Can J Anesth. 2003; 50(1): 32-5.
47. Smith NT, Benthuysen JL, Bickford RG, Sanford TJ, Blasco T, Duke PC, Seizures during opioid anesthetic induction-are they opioid-induced rigidity? Anesthesiology 1989;71:85242.
48. Fahnenstich H, Steffan J, Kau N, Bartmann P. Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants. Crit Care Med. 2000; 28 (3): 836-9.
49. Bailey P, Wilbrink J, Zwanikken P, Pace N, Stanley T. Anesthetic Induction with Fentanyl. Anesth Analg. 1985; 64: 48-53.
50. Lui PW. Involvement of spinal adenosine A1 and A2 receptors in fentanyl-induced muscular rigidity in the rat. Neurosci Lett. 1997; 224(3): 189-92.
How to Cite
1.
Tafur LA, Serna AM, Lema E. Phentanyl PK/PD, a valid drug. Colomb. J. Anesthesiol. [Internet]. 2010 Jan. 1 [cited 2024 May 7];38(1):68-83. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/311
Downloads
Download data is not yet available.
Published
2010-01-01
How to Cite
1.
Tafur LA, Serna AM, Lema E. Phentanyl PK/PD, a valid drug. Colomb. J. Anesthesiol. [Internet]. 2010 Jan. 1 [cited 2024 May 7];38(1):68-83. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/311
Issue
Section
Essay
Altmetric
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
