Understanding Anesthesiology - The Global Regional Anesthesia ...

Fentanyl
Class
Synthetic opioid analgesic (intermediate-acting); adjunct to anesthesia. Fentanyl can be used
as an additive to spinal and epidural anesthesia/analgesia.
Mechanism of Action
Acts at the mu-and kappa opioid receptors.
Dose
General anesthesia: 1-20 ug/kg IV according to physical status, other agents used, duration
and nature of surgery.
Onset
IV 4-6 minutes
Duration
IV 30-45 minutes
Elimination
Hepatic
Effects
CNS
Potent analgesic effects; some sedative effect. Rarely causes blurred vision, seizures. All of the
depressant effects of fentanyl are potentiated by concurrent use of sedatives, volatile anesthetics
and nitrous oxide.
CVS
Hypotension, bradycardia. The synthetic opioids are not direct myocardial depressants but
they do reduce sympathetic drive which may result in decreased cardiac output in patients
who are relying on sympathetic tone to support their circulation such as those in hypovolemic
or cardiogenic shock.
Respiratory
Respiratory depression which at the extreme leads to apnea.
GI
Nausea, vomiting, biliary tract spasm, constipation.
Misc
Muscle rigidity
Related Glossary Terms
Alfentanil, Analgesia, Apneic threshold, Balanced anesthesia, Epidural analgesia, Epidural
anesthesia, Four A’s of anesthesia, Morphine Sulfate, Naloxone, Opioids, Remifentanil,
Sufentanil
Index
Find Term
Chapter 3 - Anesthetic Techniques
Chapter 3 - Regional Anesthesia
Chapter 3 - General Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Opioid agonists and antagonists