NAME OF DRUG
alfentanil citrate

CLASSIFICATION

Narcotic Analgesic

ALTERNATE NAMES

ALFENTA

INDICATIONS

• as an analgesic adjunct in the induction and maintenance of anesthesia, especially for surgical procedures of short duration

RECONSTITUTION AND STABILITY

• store at room temperature; protect from light

COMPATIBILITY

• compatible with commonly used IV solutions

ROUTES OF ADMINISTRATION

• IV direct
• IV infusion

VH & HSC ADMINISTRATION POLICY

Restricted to bronchoscopy

C - Must be administered by the physician by all routes.

H - IV infusion administration rate must be controlled by an automated infusion device.

DOSAGE

Adults:

• anesthesia less than 30 min:  5-20 mcg/kg with incremental increases of 2.5 mcg/kg to a maximum of 40 mcg/kg
• anesthesia of 30-60 min:  20-50 mcg/kg with incremental increases of 5-15 mcg/kg to a maximum of 75 mcg/kg
• anesthesia greater than 45 min:  50-75 mcg/kg, followed by an infusion of 0.5-1.5 mcg/kg/min

Conscious Analgesia:

• 5-10 mcg/kg, followed by 1-3 mcg/kg/minute

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• skeletal and thoracic muscle rigidity, especially with too rapid IV
• respiratory, circulatory depression; bradycardia or tachycardia

IMPORTANT IMPLICATIONS

• resuscitation equipment must be readily available
• antidote:  naloxone
• reduce dosage in the elderly
• dosage should be determined on the basis of lean body weight in obese patients
• contraindicated in patients allergic to fentanyl and its derivatives

• may potentiate or be potentiated by other CNS and respiratory depressants

Rev. Mar 2008