Borel J D
Contemp Anesth Pract. 1983;7:1-18.
Recent research has led to the development of a new family of synthetic narcotic fentanyl derivatives. Two of these, sufentanil and alfentanil, are already in clinical use abroad and are presently under clinical investigation in the United States. Sufentanil is more potent than fentanyl and is claimed to have fewer side effects and less variability in patient cardiovascular responses under stress. It appears that its primary application will be for high-dose narcotic anesthesia in patients with cardiovascular disease. Alfentanil has a shorter duration of action and is claimed to have less postoperative ventilatory depression than fentanyl. It is being recommended for use via continuous intravenous infusion. It will probably become a popular anesthetic agent for outpatient and short surgical procedures. It should be remembered that at this time very little information concerning these agents is in print. Most of the research has been done by a handful of investigators and much has not been published in peer review publications. Based on the clinical impressions of our European colleagues, one can say that these agents should be as safe and as reliable as fentanyl, but any clinically significant advantages over their parent compound, especially in the case of sufentanil, will have to await more widespread use and controlled investigation.
最近的研究促成了一类新型合成麻醉性芬太尼衍生物的开发。其中两种，舒芬太尼和阿芬太尼，已在国外临床使用，目前正在美国进行临床研究。舒芬太尼比芬太尼效力更强，据称副作用更少，在应激状态下患者心血管反应的变异性也更小。其主要应用似乎将是用于心血管疾病患者的大剂量麻醉。阿芬太尼作用持续时间较短，据称术后通气抑制比芬太尼轻。建议通过持续静脉输注使用。它可能会成为门诊和短时间外科手术中常用的麻醉剂。应当记住，目前关于这些药物的公开信息非常少。大多数研究是由少数研究人员完成的，很多研究尚未在同行评审出版物上发表。根据我们欧洲同事的临床印象，可以说这些药物应该和芬太尼一样安全可靠，但相对于其母体化合物而言，任何具有临床意义的优势，尤其是舒芬太尼的优势，都有待更广泛的使用和对照研究。
