[Clinical use of alfentanil]

The fentanyl derivative alfentanil is a potent analgesic characterized by a quick onset time, short duration of action, low toxicity and short elimination time. Alfentanil is mainly used intraoperatively. In minor operations, its intravenous application is sufficient for anaesthesia. In major operations, the need for other anaesthetics can be reduced by the application of alfentanil. The best form of application is the computer-controlled infusion of alfentanil. The advantage of alfentanil over other opioids is the short recovery time of the patient. Alfentanil can also be used postoperatively for pain relief. Used intravenously after abdominal operations, it is approximately ten times more effective than morphine. Applied peridurally its analgesic effect corresponds approximately to that of morphine. Based on the lower amount of alfentanil needed, the patient-controlled application of alfentanil is superior to the use of constant infusion rates. In combination with midazolam, alfentanil can also be used for analgosedation of intensive care patients. Alfentanil is less useful for the treatment of cancer pain since it leads to greater development of tolerance than other opioids.