How to Use Fentanyl in Clinical Anesthesia

Abstract

  Many anesthesiologists in Japan seem to misunderstand that the use of fentanyl during anesthesia may lead to a delay in recovery from anesthesia. This idea is apparently incorrect. With the knowledge of the pharmacokinetic and pharmacodynamic features of fentanyl, we can adequately manage the antinociception during anesthesia without any delay in recovery from anesthesia and without respiratory depression. In most cases, more than 1. 5 ng/ml of ESC (effect site concentration) is required to obtain adequate analgesia during surgery. And the incidence of respiratory depression increases when ESC of fentanyl becomes more than 2. 0 ng/ml. We also should have the knowledge of how to use naloxone, the opioid antagonist, in case there is an overdose of fentanyl after the operation is finished. We should know that antinociception during surgery is the key for good anesthesia induction.