Sufentanil and alfentanil pattern of consumption during patient-controlled analgesia: a comparison with morphine

Pattern of drug consumption and side effects of sufentanil and alfentanil were compared to morphine, using "on-demand" patient-controlled analgesia (PCA). After a non-narcotic general anesthetic, a bolus dose of the narcotic was given intravenously towards the end of surgery. PCA was started in the recovery room. Data were retrieved postoperatively for a total of 24 h. Results showed a wide range of pattern of drug consumption and uniform acceptance of therapy by the nurses and the patients in all the groups. The frequency of use of incremental doses was greater than 2-2.5-fold for the sufentanil and alfentanil groups, respectively, compared with morphine. The bolus dose of the narcotics failed to achieve adequate analgesia for 2 h for morphine and sufentanil and for 6 h for alfentanil. Overall patients were most sedated with morphine and least sedated with sufentanil. At the time intervals sampled, there was a higher incidence of oxygen desaturation--less less than 95% with morphine and alfentanil, compared with sufentanil. There was a similar incidence of nausea in all the groups. Further study is needed to determine precisely the best dose regimens for sufentanil and alfentanil, especially in reference to optimum loading doses. Sufentanil appears to be a promising drug for PCA use.