Medication Description: Fentanyl (Phentanylum)
FENTANIL (Phentanylum). 1- (2-Phenylethyl) -4- (N-propionylphenylamino) -piperidine.
White crystalline powder. Practically insoluble in water. Easily soluble in alcohol.
Available in citrate (Phentanyli citras, Phentanylum citricum).
Synonyms: Centonil, 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 injection) analgesic effect.
After intravenous administration, the maximum effect develops in 1–3 minutes and lasts 15–30 minutes. After intramuscular administration, the maximum effect occurs within 3 to 10 minutes.
Apply mainly to neuroleptanalgesia in combination with neuroleptics (see Droperidol). Is part of the combined drug talamonal (see).
For drug preparation for anesthesia (premedication), fentanyl is administered in a dose of 0.05-0.1 mg (1-2 ml of a 0.005% solution) intramuscularly half an hour before surgery.
To achieve neuroleptanalgesia, a neuroleptic is first administered, then fentanyl at the rate of 1 ml of a 0.005% solution for every 5 kg of the patient’s body weight. Enter the drug slowly - intravenously. For induction anesthesia, half the dose of fentanyl can be used, followed by the introduction of reduced doses of barbiturates or other means for anesthesia (combined induction).
As a rule, after the use of neuroleptic and fentanyl, a muscle relaxant is administered to the patient, the trachea is intubated and auxiliary or artificial ventilation of the lungs is carried out with oxygen or oxygen mixture with nitrous oxide or other inhalation anesthetics in reduced concentrations. To maintain analgesia, if necessary, add an additional 1-3 ml of 0.005% fentanyl solution every 10 to 30 minutes.
In case of short-term extra cavity operations, when the use of muscle relaxants is not required and neuroleptic algesia is carried out with preservation of spontaneous breathing, fentanyl is injected at the rate of 1 ml of 0.005% solution for every 10-20 kg of body weight. At the same time, it is necessary to monitor the adequacy of spontaneous breathing. You must be able to make, if you need tracheal intubation and artificial respiration. In the absence of conditions for artificial lung ventilation, the use of fentanyl for neuroleptic algesia is unacceptable.
In operations under local anesthesia, fentanyl (usually in combination with a neuroleptic) can be used as an additional analgesic. Introduce intravenously or intramuscularly 0.5-1 ml of a 0.005% solution of fentanyl (if necessary, the drug can be repeated every 20-40 minutes).
Fentanyl can be used to relieve acute pain in myocardial infarction, angina pectoris, pulmonary infarction, renal and hepatic colic. Injected intramuscularly or intravenously 0.5 - 1 - 2 ml of 0.005% solution. Fentanyl is often used for this purpose in combination with antipsychotic drugs.