Alfentanil and sufentanil: Towards a more specific use of narcotics in anesthesia

Abstract Molecular redesign of existing compounds has led to the development of narcotic agents such as alfentanil and sufentanil, which may allow a greater and more specific use of narcotics in clinical anesthesia. The rapid onset and short duration of action makes alfentanil very suitable in those situations where rapid suppression of reflex responses is required (e.g., peroperative supplementation during stressful moments) or where longer acting compounds are less appropriate (e.g., short surgical procedures). The high specificity and potency of sufentanil provide deeper analgesia and a more complete stress protection than existing narcotics, without increasing postoperative depression. These characteristics make sufentanil especially beneficial in those situations where high doses are required (e.g., major surgical procedures such as cardiac surgery).