Clinical use of sufentanil as an anesthetic.

This review considers a few of the controversies and most recent data pertaining to the clinical intraoperative use of the potent opioid sufentanil. Although sufentanil is used extensively as the opioid component of "balanced" anesthesia, opioids themselves are not total anesthetics. Sufentanil is effective in reducing the so-called stress responses that can occur with balanced anesthesia. Although no conclusive data have shown that such reduction in stress response improves anesthetic outcome, many clinicians continue to choose sufentanil for both convenience and improved hemodynamic control. Recent pharmacokinetic modeling suggests that sufentanil would be a good choice for balanced anesthesia. Additionally, initial postoperative analgesia appears to work better when sufentanil rather than fentanyl is used intraoperatively. Although cost considerations remain important, cost analysis would suggest that, on a per-patient basis, choice of intraoperative opioid has very little effect on total hospital costs.