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fentanyl (Fentanyl Dura / fentanyl, Lavipharm / fentanyl, Recordati)

✓ Approved

Lavipharm · OPRD1 · 小分子

什么是 fentanyl？

fentanyl 是一种小分子，由Lavipharm研发。该药已获批，用于治疗相关适应症，给药途径：Transdermal。

药物档案

商品名Fentanyl Dura, fentanyl, Lavipharm, fentanyl, Recordati
公司Lavipharm
药物类别小分子
分子靶点OPRD1, OPRK1, OPRM1
给药途径Transdermal
状态Approved
来源： ClinicalTrials.gov, Lavipharm

作用机制

分子靶点

fentanyl 作用于 3 个分子靶点：

OPRD1opioid receptor delta 1 (DOR, OPRD)
OPRK1opioid receptor kappa 1 (KOR1, OPRK)
OPRM1opioid receptor mu 1 (MOR1, LMOR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

fentanyl 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Gastrointestinal disordersAbdominal pain✓ Approved

相关研究文献

PubMedSaudi journal of anaesthesia2026-08-05

Asystole during laryngoscopy with a videolaryngoscope in a patient with an anticipated difficult airway: A case report.

Osawa Ryosuke R, Tsurumachi Naoi N, Tamura Yohei Y, Arai Takero T

Asystole during tracheal intubation using a direct laryngoscope has been reported, but there has been no report of asystole during tracheal intubation using a videolaryngoscope. We report a case of asystole during videolaryngoscopy in a 76-year-old woman with marked tracheal deviation caused by a large thyroid adenoma. General anesthesia was induced with remimazolam 6 mg/kg/h, fentanyl 0.1 mg, and remifentanil 0.25 μg/kg/min, under apneic oxygenation using high-flow nasal oxygenation. After administration of rocuronium 40 mg, a McGrath™ MAC videolaryngoscope provided an excellent glottic view. Immediately before tracheal tube insertion, sudden bradycardia progressed to asystole. Laryngoscopy was discontinued, and intravenous atropine 0.5 mg was administered, resulting in the return of spontaneous cardiac activity within 10 s without chest compressions. The patient's vital signs remained stable after the event, and tracheal intubation was achieved without further complications. Anesthesiologists should remain vigilant for this rare but potentially life-threatening complication.

PMID 42553871
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PubMedSaudi journal of anaesthesia2026-08-05

A novel fascial plane block for pediatric open pyeloplasty: Clinical experience with the quadro-iliac plane block-A report of five cases.

Bhokare Himangi H, Kewlani Anu A

Open pyeloplasty in children is often associated with significant postoperative pain, and providing effective analgesia while limiting opioid exposure remains challenging. We describe our experience with the ultrasound-guided Quadro-Iliac Plane Block (QIPB), a recently described fascial plane block, in five children aged 2-7 years undergoing open pyeloplasty. Following induction of general anesthesia, a unilateral QIPB was performed using 0.2% ropivacaine (0.5 mL/kg). Postoperative pain was assessed using the FLACC scale over 24 hours, and the need for rescue analgesia was documented. All children had low pain scores in the early postoperative period, with median FLACC scores remaining ≤3. Three patients required a single dose of rescue fentanyl between 13 and 16 hours postoperatively, likely corresponding to block wear-off. No adverse effects, motor weakness, nausea, or vomiting were observed. Our experience suggests that QIPB may offer effective, opioid-sparing, and motor-preserving analgesia for pediatric open pyeloplasty, although larger controlled studies are needed.

PMID 42553757
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PubMedTopics in companion animal medicine2026-08-04

Effect of 24-hour sedation during mechanical ventilation on hematological, biochemical, and coagulation parameters in bitches: a randomized clinical study.

Regalin Doughlas D, Adorno Barbara Ataíde BA, Chimenes Natielly Dias ND, Ribeiro Diego D et al.

The effects of prolonged sedation on hematological, biochemical, and coagulation variables have not been previously investigated in veterinary medicine. Twelve healthy adult mixed-breed female dogs were included. Blood samples (6 mL) were collected at baseline (M0) for complete blood count (CBC), biochemical testing, prothrombin time (PT), activated partial thromboplastin time (PTT) and fibrinogen. After M0, dogs were allocated into two groups: midazolam-fentanyl-propofol group (MFG; n=6), which received a continuous infusion of midazolam (0.5 mg/kg/h), fentanyl (10 µg/kg/h), and propofol (18 mg/kg/h); and ketamine-morphine-propofol group (KMG; n=6), which received a continuous infusion of ketamine (0.6 mg/kg/h), morphine (0.26 mg/kg/h), and propofol (18 mg/kg/h). The infusion was maintained for 24 hours under mechanical ventilation. Laboratory parameters were reassessed from 12 and 24 hours after the beginning of infusion (M12 and M24), and at 12, 24, and 48 hours after the infusion (T12, T24, and T48). Both protocols significantly reduced erythrocyte count, packed cell volume, and haemoglobin concentration. In KMG, TTP decreased significantly at M12, M24, and T24; TSP at M24; and lymphocytes at M12 and M24. No significant changes were observed in ALP, ALT, albumin, globulins, creatinine, urea, glucose and blood coagulation. Triglyceride and cholesterol concentrations increased significantly from M6 to T48, but without biochemical evidence of hepatic, renal, or coagulation impairment. Overall, both protocols induced transient hematological and biochemical changes without clinically meaningful alterations in hepatic or renal function, supporting their use in healthy dogs mechanically ventilated for 24 hours.

PMID 42546968
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PubMedPain physician2026-08-04

Prolonging Peripheral Nerve Blocks in Adults: A Narrative Review of Adjunct Medications for Single-Injection Techniques.

Jha Sachin Sunny SS

Single-injection peripheral nerve blocks (PNBs) are a cornerstone of multimodal perioperative analgesia. However, the duration of commonly used long-acting local anesthetics is finite; many patients experience abrupt and sometimes severe "rebound pain" as the block resolves. This phenomenon is particularly prominent after painful orthopedic procedures and may increase early opioid consumption and reduce patient satisfaction. To review the effectiveness and safety of pharmacologic adjuncts used to prolong adult single-injection PNBs and to provide practical, clinically oriented recommendations for their use. Narrative review. I conducted a focused narrative review of randomized controlled trials, observational studies, and systematic reviews or meta-analyses evaluating adjunct medications administered with single-injection PNBs in adults. The agents considered were dexamethasone, dexmedetomidine, clonidine, morphine, fentanyl, buprenorphine, magnesium sulfate, midazolam, and ketamine. The outcomes of interest were sensory block duration and analgesia, postoperative opioid consumption, rebound pain, and adverse events. Dexamethasone, given intravenously or perineurally, consistently prolongs analgesia by approximately 6-8 hours and reduces early opioid use. Buprenorphine, administered perineurally, often extends analgesia to 24-48 hours but increases postoperative nausea. Dexmedetomidine modestly prolongs a block's duration and improves a block's quality, but is associated with dose-dependent bradycardia, hypotension, and sedation. Clonidine yields smaller gains in a block's duration with similar hemodynamic and sedative concerns to dexmedetomidine. Magnesium sulfate and midazolam produce modest and more variable benefits. Ketamine has inconsistent effects on a block's duration but may help mitigate hyperalgesia in select patients. Conventional opioids (morphine, fentanyl) provide little incremental benefit as perineural adjuncts; they also increase opioid-typical adverse effects. This is a narrative rather than a systematic review; heterogeneity among studies in block type, local anesthetic formulation, dosing, and outcome definitions precludes pooled quantitative estimates. Dexamethasone and buprenorphine have the strongest and most consistent evidence for clinically meaningful prolongation of single-injection PNBs in adults and may be considered first-line adjuncts in appropriate patients. Dexmedetomidine, clonidine, magnesium, midazolam, and ketamine may be useful in some situations when their specific benefit-risk profiles are acceptable. Conventional opioids offer little advantage as perineural adjuncts and are not recommended for routine use. Evidence-based selection of adjuncts within a multimodal analgesic strategy can improve postoperative analgesia, reduce opioid exposure, and potentially attenuate rebound pain.

PMID 42550518
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PubMedForensic science, medicine, and pathology2026-08-03

New trends in the overdose epidemic: postural impact on abusers of fentanyl and xylazine and clinical and forensic implications.

da Silva Manuela Luís Oliveira MLO, Barbosa Joana J, Dinis-Oliveira Ricardo Jorge RJ

The illegal drug trade has changed dangerously since xylazine, a veterinary α2 adrenergic agonist, has become a common additive in illegally made fentanyl, creating the "tranq dope" mix. Together, they cause a synergistic central nervous system and respiratory depression that is more severe than that observed with opioid toxicity alone. This raises important questions about awareness, stigma, and clinicians' responses. A scoping review was performed in accordance with PRISMA-ScR guidelines, utilizing a PCC-structured research question. Studies examining fentanyl and/or xylazine exposure with clinically or toxicologically significant data were searched in PubMed and ScienceDirect. 38 studies were included, most from North America, including case reports, retrospective studies, narrative reviews, animal studies, qualitative research, and toxicological analyses. Co-exposure to fentanyl and xylazine has been linked to severe necrotic cutaneous ulcers, unique postural phenomena like the forward-flexed "fentanyl fold," acute muscle rigidity, including Wooden Chest Syndrome, and synergistic respiratory depression. Naloxone reverses the opioid component but does not counteract the sedative effects of xylazine, making overdose management more difficult and necessitating multimodal strategies like wound care, oxygenation support, and increased drug-checking services. Exposure to fentanyl-xylazine calls into question established models of opioid overdose and necessitates coordinated clinical and public health interventions. To combat this rapidly evolving threat, stigma must be reduced, harm reduction infrastructure expanded, and prospective research funded.

PMID 42545627
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PubMedThe Journal of physiology2026-08-03

On the adaptive significance of group III/IV muscle afferent feedback for the cardiovascular response during sustained locomotion in humans.

Iannetta D D, Laginestra F G FG, Thurston T S TS, Jenkinson R H RH et al.

While the cardiovascular consequences of group III/IV muscle afferent feedback have been studied during short-duration exercise, its role during sustained (> 5 min) locomotion remains unknown. Thirteen healthy individuals (4f/9m) completed two 20-min cycling bouts at ∼50% (moderate) and ∼75% (heavy) of V . O 2 max with intact (CTRL) and pharmacologically attenuated (FENT; lumbar intrathecal fentanyl) group III/IV leg muscle afferent feedback. Cardiac output (CO), mean arterial pressure (MAP), leg blood flow (LBF) and leg vascular conductance (LVC) were quantified. While cardiovascular responses at rest were not different between conditions, afferent blockade reduced CO during the moderate-intensity exercise (P = 0.006), with the impact progressively strengthening over time (P = 0.027). These effects were absent during the heavy-intensity bout (P = 0.741). For moderate-intensity exercise, MAP was consistently ∼10% lower (P < 0.001) and LVC ∼13% higher (P = 0.006) during FENT compared to CTRL. During heavy-intensity exercise, MAP was steadily ∼14% lower during FENT (P < 0.001) and LVC was higher (P < 0.001) with progressive increases over time (P = 0.019). Afferent blockade had no effect on LBF throughout the moderate-intensity exercise (P = 0.407). However, during heavy-intensity exercise, starting from minute 10, there was a between-condition difference, resulting in a significantly higher LBF (∼9%) during FENT compared to CTRL (P = 0.010). These findings highlight the importance of group III/IV leg muscle afferent feedback for regulating the cardiovascular response to human locomotion but also indicate that its relative contribution varies with the intensity and duration of the exercise. KEY POINTS: While the cardiovascular significance of group III/IV muscle afferent feedback has been investigated during short-duration exercise (≤5 min), its functional relevance during prolonged locomotion is unknown. Using lumbar intrathecal fentanyl to attenuate leg muscle afferent feedback during 20-min cycling bouts at ∼50% and ∼75% V . O 2 max , we found that these afferents consistently facilitate blood pressure, with effects amplifying with intensity. They also progressively restrict leg vascular conductance, particularly during heavy-intensity exercise, creating a cumulative constraint on blood flow that emerges over time rather than immediately. We also found that group III/IV muscle-afferents augment cardiac output during moderate-intensity exercise, with this effect strengthening over time. However, this facilitation disappears completely during heavy-intensity exercise. These findings demonstrate that muscle afferent feedback dynamically modulates haemodynamic responses during sustained locomotion, with cardiovascular contributions varying substantially based on both exercise intensity and duration, a complexity not apparent in short-duration protocols.

PMID 42546182
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