舒芬太尼的药理作用及其在颌面外科麻醉中的临床应用

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舒芬太尼在上世纪七十年代由人工研制而成,是目前阿片类镇痛药物中效果最强的。舒芬太尼可以和阿片类μ受体高度选择性的结合,从而发挥其药理作用,其镇痛效果十分强大。因超过90%的舒芬太尼可与血浆蛋白结合,且因其容易透过血-脑屏障,所以其达到有效血药浓度的速度十分快速。舒芬太尼主要在肝脏代谢,从肾脏以原形排出的药物<1%,可经静脉给药,且对患者全身血流动力学的影响小,脂溶性强,是一种强效阿片类镇痛药。临床应用于全麻诱导,术中维持及术后镇痛,插管反应小,血流动力学平稳,术后苏醒快,呼吸抑制轻,镇痛效果强,尤其适用于颌面外科患者麻醉的诱导和维持,也可用于患者术后镇痛。给药途径多样,可经静脉、鼻腔、眼结膜等给药。临床应用安全,可靠,效果优于芬太尼,值得推广。“,”Sufentanil was made artiifcially in the 1970s, having the strongest analgesic effect in the opioids currently. Sufentanil can be highly selective combined with μ opioid receptor, thus exerts its pharmacological effect, which is obvious. For more than 90% of sufentanil can combine with plasma proteins,and be easy to cross the blood-brain barrier,so it can fast reach the effective blood drug concentration.Sufentanil mainly metabolizes in the liver and its residues discharging from the kidney are to 1%.It may be administered intravenously, and has small hemodynamic impacts on patients and strong fat-soluble.So it is a potent opioid. Clinically,it is applied in the induction of general anesthesia, intraoperative and postoperative analgesia,having a series of advantages,such as small intubation response,stable hemodynamics, quick recovery after operation,light respiratory depression,strong analgesic effect.Especially being suitable for patients who should be given anesthesia induction and maintenance or postoperative analgesia.There are various administration by vein , nose, eye conjunctiva, etc.It is safe and reliable clinically. The effect is better than that of fentanyl.And it is worthy of promotion.
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