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Ch 5 · Pharmacology

Rational IV Opioid Use

Fentanyl, hydromorphone, morphine, remifentanil, sufentanil — when and why.

8 min read

Key Points

  • Analgesia via μ-opioid agonism (PAG in brain, substantia gelatinosa in cord).
  • All opioids cause respiratory depression, sedation, miosis, ileus, pruritus. Hemodynamically stable when given alone.
  • Fentanyl: rapid onset; long context-sensitive half-time on infusion.
  • Remifentanil: organ-independent ester metabolism, ~5–10 min duration regardless of infusion length. Sudden cessation → acute opioid tolerance.
  • Hydromorphone: longer-acting, no histamine release. Preferred in renal failure (M3G no active analgesic metabolite).

01Basic Opioid Pharmacology

Analgesia is produced by μ (mu) opioid receptor agonism: - In the brain (periaqueductal gray matter) - In the spinal cord (substantia gelatinosa)

Side-effect profile is consistent across the class: - Sedation, respiratory depression - Chest-wall rigidity (rapid bolus of potent fentanyl/sufentanil/remifentanil) - Bradycardia, hypotension (especially with other anesthetics) - Pruritus, nausea, ileus, urinary retention - Miosis (useful to assess patients under GA) - Reduce MAC of volatile anesthetics.

Opioids alone are hemodynamically stable; in combination with volatiles or propofol they ↓ CO/SV/BP.

02Opioid Receptor Subtypes

ReceptorClinical effectAgonists
μ (mu)Supraspinal analgesia (μ1), respiratory depression (μ2), physical dependence, muscle rigidityMorphine, fentanyl, met-enkephalin, β-endorphin
κ (kappa)Sedation, spinal analgesiaNalbuphine, butorphanol, dynorphin, oxycodone
δ (delta)Analgesia, behavioral, epileptogenicLeu-enkephalin, β-endorphin
σ (sigma)Dysphoria, hallucinationsPentazocine, ketamine

03Opioid Comparison

DrugEquianalgesic IVPeakDuration (single bolus)Infusion?
Fentanyl50 mcg3–5 min30–60 minUse with caution*
Alfentanil150–250 mcg1–2 min5–10 minUncommon
Sufentanil5 mcg3–5 min20–45 minOR
Remifentanil50 mcg3–5 min5–10 minOR
Morphine5 mg10–20 min4–5 hICU/comfort
Hydromorphone0.75 mg5–15 min2–4 hICU
Meperidine37.5 mg5–15 min2–4 hNo
Methadone2.5 mg10 min24 hNo

*Fentanyl infusion: long context-sensitive half-time — predict prolonged duration after stopping.

04Fentanyl

  • Synthetic phenylpiperidine; 75–125× more potent than morphine.
  • Easy to titrate — rapid onset and short duration after a single bolus.
  • Frequently used to blunt sympathetic response to laryngoscopy / LMA placement.
  • Context-sensitive half-time grows dramatically with infusion — cut dose in half every 2 hours and expect a prolonged tail.
  • No histamine release; no active metabolites.

05Hydromorphone

  • 5–7× more potent than morphine.
  • Longer duration of action (2–4 h) → workhorse for postoperative analgesia and PCA.
  • Titrate to effect near end of case for smooth wakeup — peak effect can take ~15 min.
  • Metabolite (hydromorphone-3-glucuronide) has no analgesic activity but can cause neuroexcitation in renal failure.
  • No histamine release.
  • Preferred over morphine in renal failure.

06Remifentanil

  • Esterase-metabolized (plasma esterases) → context-INSENSITIVE half-time (~5–10 min regardless of duration).
  • Infusion: start 0.05–0.1 mcg/kg/min, titrate as needed (rarely > 0.3 mcg/kg/min).
  • Useful when intense intraoperative stimulation but minimal post-op pain expected, OR when paralysis is contraindicated (neuromonitoring).
  • Bradycardia is common — have glycopyrrolate or atropine ready for bolus dosing.
  • Sudden cessation → acute opioid tolerance (within minutes). Treatable with more opioid.
  • Long, high-dose infusions (> 0.15 mcg/kg/min) → opioid-induced hyperalgesia. Less responsive to additional opioid.
  • Always have a longer-acting opioid on board before stopping the infusion.
  • Dosing units: mcg/kg/MIN (not /hr — don't confuse with sufentanil dosing).

07Sufentanil

  • 5–10× more potent than fentanyl.
  • High-dose cardiac induction provides exceptional hemodynamic stability.
  • Infusion dosing mcg/kg/HOUR (not /min — common error).
  • Useful neuraxially (intrathecal/epidural).

08Morphine

  • Natural opioid; histamine release → hypotension, urticaria.
  • Active metabolite morphine-6-glucuronide is renally cleared → accumulates in renal failure with prolonged sedation/respiratory depression.
  • Intrathecal morphine (Duramorph): excellent post-op analgesia up to 24 h. Monitor for delayed respiratory depression.

09Strategies for Opioid Use

  • Standard GETA: use fentanyl to blunt sympathetic response to laryngoscopy; transition to longer-acting hydromorphone before incision; titrate near end of case based on RR.
  • Short ambulatory cases: smaller doses of fentanyl ± local infiltration.
  • Painful surgery, smooth wakeup needed: load with hydromorphone early; use remifentanil infusion for moment-to-moment titration; assess RR on wean.
  • OSA / opioid-sparing: multimodal (acetaminophen, NSAID, regional, ketamine infusion, dexmedetomidine).
  • Anticipate respiratory depression in PACU when redosing after a case.

References & Further Reading

  1. 1
    Textbook

    Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.

  2. 2
    Textbook

    Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.

  3. 3
    Textbook

    Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, Holt NF. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017.

  4. 4
    Textbook

    Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.