Pharmacology of Epidural Fentanyl, Alfentanil, and Sufentanil in Volunteers

摘要: Background Despite a large number of clinical investigations in postoperative patients, the pharmacology epidural fentanyl, alfentanil, and sufentanil has not been well characterized human laboratory setting. In this double-blind, placebo-controlled crossover study, we evaluated analgesia side effects produced by fentanyl (30 100 micrograms), alfentanil (300 1,000 (3 10 micrograms) volunteers. Methods Each 12 volunteers participated four separate study sessions. The pain model was cutaneous electrical stimulation intensity sufficient to produce report 5 on 0-5 scale, delivered alternately finger tow. Ventilatory drive, pupil size, subjective ratings alertness, nausea, pruritus were measured using visual analog scales. On each day, after baseline measurements, an catheter placed at L2-L3 or L3-L4 interspace. Subjects received small dose drug, tests repeated 2, 55, 95 min drug administration. then same series later. Plasma opioid concentrations gas chromatography-mass spectrometry. Results Dose-dependent found for all opioids. For both doses opioids, toe significantly greater than analgesia. Epidural provided investigated. Sedation, increased end-tidal carbon dioxide, pupillary constriction occurred only Overall, incidence low, but subjects experienced micrograms nauseated alfentanil. near minimum effective analgesic plasma larger doses. Conclusions Lumbar selective lower-extremity Low suggest spinal mechanism Larger opioids result systemic absorption are likely supraspinal other effects.