阿芬太尼的临床药理特性及其麻醉应用进展

阿芬太尼是合成的作用于μ阿片受体的芬太尼衍生物，为短效强镇痛药。相比于芬太尼和舒芬太尼等类似的麻醉药，阿芬太尼的效价最低，起效最快，作用时间更短，静注后1.4 min作用达峰，维持时间10～15 min，分布容积小，符合三室模型，经肝脏代谢失活后经尿排出。阿芬太尼作为芬太尼家族较早应用的药物，在镇痛、镇静、抗焦虑、麻醉诱导和维持等方面已得到广泛应用。近年来，阿芬太尼的应用更加倾向于短小操作、日间手术、保留自主呼吸以及门诊诊疗的麻醉。随着国产阿芬太尼近期研制成功，并逐渐开始在麻醉中应用，阿芬太尼有望成为临床镇痛的新选择，但目前其临床应用经验和相关研究十分有限。本文就阿芬太尼的药理作用特点及在国内外的应用进展作一综述，以期为该药的临床合理应用提供参考。

Clinical pharmacological properties of alfentanil and its progress in anesthetic application

Alfentanil is a synthetic fentanyl derivative acting on μ opioid receptors. It is a short-acting strong analgesic. Compared with similar anesthetic drugs such as fentanyl and sufentanil, alfentanil had the lowest titer, the fastest effect, and shorter action time. The effect reached the peak 1.4 min after intravenous injection, and the maintenance time was 10-15 min. The distribution volume was small, which was in line with the three-compartment model, and was excreted through urine after liver metabolism inactivation. Alfentanil, one of the earliest drugs in the fentanyl family, has been widely used in analgesia, sedation, anti-anxiety, induction and maintenance of anesthesia. In recent years, the use of alfentanil has tended to be short procedure, daytime surgery, reserved breathing, and outpatient anesthesia. With the recent successful development of domestic alfentanil and its gradual application in anesthesia, alfentanil is expected to become a new choice for clinical analgesia, but its clinical application experience and related studies are very limited at present. In this paper, the pharmacological characteristics of alfentanil and its application at home and abroad were reviewed in order to provide reference for the rational clinical application of alfentanil.