sufentanil + remifentanil

Sufentanil + remifentanil is a combination of two potent synthetic opioid analgesics used primarily as adjuncts in general anesthesia. Sufentanil is a highly selective μ1-opioid receptor agonist with strong and long-lasting analgesic effects, while remifentanil is an ultra-short-acting μ-opioid receptor agonist characterized by rapid onset and offset due to its metabolism by non-specific esterases in blood and tissues. When used together, these drugs can provide synergistic analgesia, stabilize perioperative hemodynamics, reduce stress hormone levels, and allow for lower individual doses of each opioid. This combination may also help mitigate some adverse effects associated with the use of either drug alone—such as reducing the risk of opioid-induced hyperalgesia seen with remifentanil monotherapy—while maintaining effective pain control during surgery[3][6]. The combined use does not result in metabolic interference between the two agents due to their distinct metabolic pathways[3].