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Published on: September 24, 2020
Sufentanil in Intensive Care: A Narrative Review
Jose M Gomez1,2, Paloma Navarro2, Álvaro Mingote-Lladó3,4
1Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Journal of Clinical Medicine
|July 28, 2026
Summary
Sufentanil offers potent analgesia and a safer metabolic profile for critically ill adults, providing precise titration and potentially reducing ventilation duration. This opioid is an excellent alternative in intensive care units (ICUs).
Area of Science:
- Pharmacology and pharmacogenomics of opioid receptor binding.
- Critical care medicine and analgosedation strategies.
- Translational research in intensive care unit (ICU) patient management.
Background:
- Intensive care medicine increasingly favors analgesia over heavy sedation.
- Sufentanil, a potent opioid, is underutilized in some regions compared to morphine and fentanyl.
- Understanding sufentanil's role in contemporary ICU analgosedation is crucial.
Purpose of the Study:
- To evaluate sufentanil's utilization in critically ill adult patients.
- To analyze sufentanil's pharmacology, indications, safety, clinical evidence, and therapeutic positioning.
- To compare sufentanil with traditional opioids in ICU settings.
Main Methods:
- Comprehensive literature search in PubMed/MEDLINE.
- Focus on translational pharmacology, safety, and clinical studies of sufentanil in critically ill adults.
- Synthesis structured according to SANRA principles for narrative reviews, including articles up to February 2026.
Main Results:
- Sufentanil has high µ-opioid receptor affinity, 10x more potent than fentanyl and 1000x more than morphine.
- It possesses a wider therapeutic index than fentanyl, allowing safe, granular titration.
- Sufentanil's inactive metabolites prevent accumulation in acute kidney injury and may reduce opioid-induced hyperalgesia (OIH).
- Clinical evidence suggests improved cerebral hemodynamic stability, reduced mechanical ventilation duration, and shorter ICU stays.
Conclusions:
- Sufentanil is a highly titratable, potent analgesic with a favorable safety and metabolic profile for ICU patients.
- It presents a valuable alternative to traditional opioids in critical care analgosedation.
- Further research directions in therapeutic positioning are warranted.
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