Alfentanil is used in medicine mainly for anesthesia. Due to its rapid onset of action combined with a short duration of action, it is used in particular for minor interventions. The opioid leaves the patient with almost no accompanying symptoms.
What is alfentanil?
Alfentanil is used in medicine primarily for anesthesia. Opioids have been widely used to anesthetize patients in recent decades. However, their mode of action may vary. Therefore, different basic substances have been established to achieve the respective effects. Alfentanil is of great importance for short-term surgical interventions. The drug can take effect after just 30 to 60 seconds and thus proves to be significantly faster compared with many other anesthetics. However, this is also associated with a relatively short duration of action. The basic substance will minimize the desired effect after about ten minutes. Depending on physical constitution and intended use, about 1.5 to 2 milligrams are administered intravenously – in some cases also transdermally – for an average adult. The alfentanil produces almost no after-effects during awakening in the patient. Subsequently, the anesthetic is broken down by the liver. This process is also completely successful.
Pharmacologic effect
After administration, alfentanil enters the body within one cycle of circulation. There it occupies the opioid receptors. They are responsible for transmitting the pain reflex within the central nervous system. However, this function is inhibited and even completely blocked for a short time. The pain as such occurs in the course of the operation, but cannot be perceived by the patient. Another effect is the sedative effect of alfentanil. It can therefore be administered in small doses even before the operation. It calms the nerves, relieves existing mental discomfort and alleviates the patient’s anxiety. The patient will thus be able to face the further procedure calmly. Compared to many other opioids, alfentanil will not show a reduction in half-life even with multiple applications. The duration of action always remains approximately the same. In contrast, most other preparations from the genus of anesthetics lose their effect with repeated use and would have to be dosed correspondingly more strongly to achieve anesthesia. Especially in the case of several operations with a small scope, of course, an advantage.
Medical application and use
The primary use of alfentanil takes place in minor procedures in the field of surgery or dentistry. Here, the pain that occurs is attenuated and consciousness is calmed. The patient does not have to receive a general anesthetic, but can remain awake during the operation. Alfentanil also has a positive effect on general anesthesia. If the previously administered anesthetic is not sufficient during an extensive operation and the end of the operation is already in sight, alfentanil can be additionally injected for the last remaining minutes. This bridges the phase in which the initially administered analgesic loses its effect. In this case, however, any interactions between the two drugs should always be investigated in advance. Since alfentanil, a member of the opioid family, has an addictive and euphoric effect, its use is strictly limited by law anyway. This is intended to counteract misuse and the occurrence of an intoxicating effect. Alfentanil is thus more frequently replaced by fentanyl, which is related to it.
Risks and side effects
Alfentanil has an intoxicating effect only at higher doses. In the context of professional anesthesia, it will not linger after ingestion or after surgery. Thus, the patient will not be drowsy or unnaturally euphoric after the procedure. Nevertheless, slight breathing difficulties may occur. Very rarely, the patient is also prone to respiratory depression. In it, the frequency of air intake decreases. In severe cases, this can result in adverse health effects. More frequently, on the other hand, a brief feeling of dizziness, trepidation and the perception of an indefinable pressure in the chest area are recorded. The ability to move the body may also be slightly reduced. A restriction of the ability to see can sometimes also be observed.The affected person should therefore not drive a car or operate any other machine after use.
