[Is sufentanil suitable for long-term sedation of a critically ill patient?]

Sedation and analgesia are commonly practised in critically ill patients. The drugs and techniques used vary widely, however. Many reports have emphasized that analgesia has to be the primary goal in every therapeutic intervention in critically ill patients. The new narcotic sufentanil has been in use since 1987 in our intensive care unit. PATIENTS AND METHODS. Forty-nine patients in our ICU received sufentanil during controlled mechanical ventilation. The dose given was 0.75-1.0 micrograms.kg bw-1.h-1. In a second part of this study sufentanil was also administered to patients during the weaning period. The dose administered was 0.25-0.35 micrograms.kg bw-1.h-1. RESULTS. With sufentanil analgesia and sedation, most of our patients could be managed well; for only five patients the amount of sufentanil given was too small (Fig. 1). Sufentanil did not show any negative influence on haemodynamic variables, such as heart rate and mean arterial pressure; in addition, serum cortisol levels were not decreased (all values within normal range; Fig. 2); during the weaning phase sufentanil 0.25-0.35 micrograms/kg also proved to be excellent; paCO2 levels did not show any tendency to increase to abnormal levels (Fig. 3). CONCLUSIONS. Analgesia and sedation with sufentanil proved to be satisfactory in critically ill patients. In a dose range of 0.75-1.0 micrograms.kg bw-1.h-1 this drug can safely be given to patients undergoing controlled mechanical ventilation. Caution is necessary in hypovolaemic patients, in whom hypotension can occur if sufentanil is administered in the recommended dose. Sufentanil in a dose range between 0.25-0.35 micrograms.kg bw-1.h-1 is safe when given to patients during the weaning period.