Pharmacodynamics, pharmacokinetics, and clinical uses of fentanyl, sufentanil, and alfentanil.

OBJECTIVE

To review the basic and clinical pharmacology of three opioids to assist in the nursing care of postoperative patients.

METHODS

The authors discuss the pharmacodynamics and pharmacokinetics of fentanyl, sufentanil, and alfentanil and compare them with other opioids. A discussion of the nursing care of patients who receive these agents both intravenously and epidurally is provided along with a nursing care plan. Common opioid-related side effects and their treatments are discussed.

CONCLUSIONS

Fentanyl, sufentanil, and alfentanil are potent synthetic opioids that are used for anesthesia and postoperative analgesia. The advantages of these opioids compared with morphine are short duration of action, lack of hyperglycemic response to surgery, decrease in catecholamine levels, and high lipid solubility. The nursing care of patients receiving these opioids involves frequent assessment of the degree of analgesia and monitoring for and treatment of side effects.