Anther remi substitution question

[kmurp]

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My specific question is with regards to Evoked potential monitoring cases. we have been using Remifentanyl as part of a balanced technique for these cases. I asked pharmacy to obtain sufentanil as a substitute as I (many years ago) used sufentanil infusions for neuro cases.
1. Does this seem like the best alternative drug to you guys?
2. I seem to recall doses of .25-.5 mcg/kg/hr for sufentanil and the need to turn it off 30-40 minutes prior to the end of the surgery. Does this seem correct.

Sorry to sound dumb but we haven't had the drug on formulary for many years.

 

[thegasman]

yes

 

[dhb]

2. I seem to recall doses of .25-.5 mcg/kg/hr for sufentanil and the need to turn it off 30-40 minutes prior to the end of the surgery. Does this seem correct.

0.5mcg/kg is a fairly high dose which will cause more accumulation and thus the need to cut the infusion 40min prior to the end. When i do sufentanil infusions i use 7.5 to 15 mcg/h which allows you to turn it off later: in 5 to 10 min the patient should resume spont ventilation.