Is sufentanil removed by blood conservation devices?

Area of Science:

• Anesthesiology
• Cardiovascular Surgery
• Pharmacology

Background:

• Cell savers and hemoconcentrators are used in open heart surgery to conserve blood.
• These devices process blood and bypass fluids, but their efficiency in recovering anesthetic drugs is not well understood.
• Supernatant from cell savers and ultrafiltrate from hemoconcentrators are typically discarded.

Purpose of the Study:

• To quantify the amount of sufentanil present in cell saver supernatant and hemoconcentrator ultrafiltrate.
• To determine the extent to which these blood conservation devices extract sufentanil from circulation.

Main Methods:

• Twenty patients undergoing open heart surgery were administered a single dose of intravenous sufentanil (30 microg/kg).
• Cell saver supernatant and hemoconcentrator ultrafiltrate were collected and analyzed for sufentanil concentration.
• Plasma sufentanil levels were monitored at various time points, including after induction, during cardiopulmonary bypass, and post-bypass.

Main Results:

• Cell saver supernatant contained only 0.1% of the total administered sufentanil dose.
• Hemoconcentrator ultrafiltrate from one manufacturer showed 0.1% recovery, while the other showed none.
• Plasma sufentanil concentrations decreased significantly over time, reaching 0.3% of the initial dose after bypass.

Conclusions:

• Intravenous sufentanil rapidly distributes out of the plasma compartment.
• Blood conservation devices like cell savers and hemoconcentrators extract negligible amounts of sufentanil.
• The low recovery suggests that sufentanil does not significantly impact the efficiency of these blood salvage techniques.