Description of the medicine: Fentanyl (Phentanylum)
FENTANIL (Phentanylum). 1- (2-Phenylethyl) -4- (N-propionylphenylamino) piperidine.
White crystalline powder. It is practically insoluble in water. Easily soluble in alcohol.
Available in the form of citrate (Phentanyli citras, Phentanylum citricum).
Synonyms: Sentonil, Fentanil, Fentanylcitrat, Fentanyli citras, Fentanyl citrate, Fentanest, Haldid, Leptanal, Sentonyl, Sublimaze.
Fentanyl is a synthetic analgesic derived from phenylpiperidine. The chemical structure is partially similar to promedol. It has a strong, but short-term (with a single administration) analgesic effect.
After intravenous administration, the maximum effect develops after 1 to 3 minutes and lasts 15 to 30 minutes. After intramuscular administration, the maximum effect occurs in 3 to 10 minutes.
Applied mainly for antipsychotics in combination with antipsychotics (see Droperidol). It is an integral part of the combined drug thalamonal (see).
For drug preparation for anesthesia (premedication), fentanyl is administered at a dose of 0.05 - 0.1 mg (1 - 2 ml of a 0.005% solution) intramuscularly half an hour before surgery.
To achieve antipsychotics, antipsychotics are preliminarily administered, then fentanyl at the rate of 1 ml of a 0.005% solution for every 5 kg of the patient’s body weight. The drug is administered slowly - intravenously. For induction of anesthesia, twice smaller doses of fentanyl can be used, followed by the introduction of reduced doses of barbiturates or other drugs for anesthesia (combined induction).
As a rule, after the use of antipsychotics and fentanyl, the patient is given a muscle relaxant, the trachea is intubated, and auxiliary or artificial ventilation of the lungs with oxygen or a mixture of oxygen with nitrous oxide or other inhaled anesthetics in reduced concentrations. To maintain analgesia, if necessary, an additional 1-3 ml of a 0.005% solution of fentanyl is added every 10 to 30 minutes.
For short non-cavity operations, when the use of muscle relaxants is not required and neuroleptanalgesia is carried out while maintaining spontaneous respiration, fentanyl is administered at the rate of 1 ml of a 0.005% solution for every 10 to 20 kg of body weight. In this case, it is necessary to monitor the adequacy of spontaneous breathing. It is necessary to be able to perform, if necessary, tracheal intubation and mechanical ventilation. In the absence of conditions for mechanical ventilation, the use of fentanyl for antipsychotics is unacceptable.
In operations under local anesthesia, fentanyl (usually in combination with an antipsychotic) can be used as an additional analgesic. 0.5 - 1 ml of a 0.005% solution of fentanyl is administered intravenously or intramuscularly (if necessary, the drug can be repeated every 20 to 40 minutes).
Fentanyl can be used to relieve acute pain in myocardial infarction, angina pectoris, pulmonary infarction, renal and hepatic colic. Enter 0.5 - 1-2 ml intramuscularly or intravenously of a 0.005% solution. Fentanyl is often used for this purpose in combination with antipsychotic drugs.