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Alfentanil is available in the following formulation:
- Alfentanil 500mcg/ml Solution: For intravenous administration
Alfentanil is a short-acting synthetic opioid analgesic used for anesthesia and procedural sedation. It has a rapid onset of action and relatively short duration compared to fentanyl, making it suitable for brief surgical procedures and as an adjunct to general anesthesia.
Alfentanil is primarily used for:
- Induction and maintenance of general anesthesia
- Analgesia during monitored anesthesia care
- Procedural sedation for brief interventions
- Supplementation of local or regional anesthesia
- Short surgical procedures requiring rapid recovery
Dosing is individualized based on the specific medical indication, patient characteristics, and concurrent medications. Typical dosage ranges include:
- For induction of anesthesia: 8-50 mcg/kg IV bolus
- For maintenance of anesthesia: 0.5-3 mcg/kg/min IV infusion, or intermittent boluses of 3-15 mcg/kg
- For procedural sedation: 3-8 mcg/kg IV bolus, followed by 0.5-1 mcg/kg/min infusion if needed
- For elderly or debilitated patients: Reduced dosages, typically 30-50% of standard doses
Important Safety Information
Alfentanil is a Schedule II controlled substance with potential for abuse and dependence. It should be administered by or under the supervision of healthcare professionals familiar with its use, specifically anesthesiologists or those trained in anesthesia administration.
Due to its potent respiratory depressant effects, Alfentanil should only be administered in settings where personnel are trained in airway management and resuscitation equipment is immediately available. Continuous monitoring of vital signs, including pulse oximetry, capnography, and blood pressure, is essential during administration.
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Common side effects include dose-dependent respiratory depression, bradycardia, hypotension, muscle rigidity (particularly with rapid administration), nausea, and vomiting. Serious adverse effects requiring immediate intervention include severe respiratory depression, chest wall rigidity, and allergic reactions.
Alfentanil should be used with caution in patients with respiratory impairment, bradyarrhythmias, hypovolemia, and in elderly or debilitated patients. Unlike remifentanil, alfentanil is primarily metabolized by the liver, so dosage adjustments may be necessary in patients with hepatic impairment.
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Alfentanil is a synthetic opioid analgesic with the following characteristics:
- Chemical Name: N-[1-[2-(4-ethyl-4,5-dihydro-5-oxo-1H-tetrazol-1-yl)ethyl]-4-(methoxymethyl)-4-piperidinyl]-N-phenylpropanamide monohydrochloride
- Mechanism of Action: Selective mu-opioid receptor agonist
- Onset of Action: 1-2 minutes when administered intravenously
- Duration of Action: 10-15 minutes after a single bolus dose
- Metabolism: Primarily hepatic via CYP3A4
- Elimination Half-life: 90-111 minutes (terminal half-life)
- Context-Sensitive Half-time: 10-15 minutes after a 30-minute infusion; increases with longer infusions
- Potency Comparison: Approximately 1/4 to 1/10 the potency of fentanyl
Alfentanil offers several clinical advantages in specific scenarios:
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- Lower incidence of delayed respiratory depression compared to longer-acting opioids
- Excellent hemodynamic stability when properly titrated
- Effective suppression of airway reflexes during intubation and extubation
- Ideal for outpatient procedures requiring rapid recovery
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