A Comprehensive Monograph on Sufentanil (DrugBank ID: DB00708): Pharmacology, Clinical Use, and Risk Management

Section 1: Executive Summary

Sufentanil is a potent, small-molecule synthetic opioid analgesic belonging to the 4-anilidopiperidine class of drugs. As a thienyl derivative of its parent compound, fentanyl, it represents one of the most powerful opioids utilized in modern clinical practice.[1] Its pharmacological profile is defined by an exceptionally high affinity and selectivity for the μ-opioid receptor, resulting in an analgesic potency estimated to be 5 to 10 times that of fentanyl and 500 to 1,000 times that of morphine.[1] This extreme potency, combined with high lipophilicity, facilitates a rapid onset of action, making it a cornerstone of anesthetic and analgesic practice in specific, high-acuity medical environments.[4]

The clinical applications of sufentanil are highly specialized and reflect its unique pharmacodynamic and pharmacokinetic properties. It is primarily administered intravenously as an analgesic adjunct to maintain balanced general anesthesia or as a primary anesthetic agent, particularly in major surgical procedures such as cardiovascular and neurosurgery, where its ability to ensure hemodynamic stability by attenuating the sympathetic stress response is highly valued.[3] Additionally, it is used via the epidural route, typically in combination with a local anesthetic like bupivacaine, to provide effective analgesia during labor and vaginal delivery.[5] A significant innovation in its delivery is the development of a sublingual tablet formulation (Dsuvia®, Dzuveo®), approved for the management of severe, acute pain exclusively within certified, medically supervised healthcare settings.[6]