Abstract
<jats:p>Sufentanil is a synthetic opioid with high lipophilicity and selective affinity for the μ1 sub-population of opioid receptors, which defines its place in the cardiac anaesthesiologist’s pharmacological arsenal. This review systematises current evidence on sufentanil pharmacokinetics, dosing in on-pump and off-pump (off-pump coronary artery bypass — OPCAB) cardiac surgeries, haemodynamic effects, ventricular-arterial coupling, myocardial protection, fast-track protocols and the safety profile. As a clinical illustration, own experience of using sufentanil as the principal opioid component of anaesthesia is presented: a series of 20 patients with coronary artery disease who underwent coronary artery bypass grafting — 18 off-pump (OPCAB) and 2 on-pump. The mean time from the endof surgery to extubation was 2.6 ± 1.1 h, consistent with fast-track cardiac anaesthesia criteria; no reintubations or haemodynamic complications were recorded. Sufentanil provides reliable haemodynamic stability compatible with early extubation, contributes toan improved early postoperative course and demonstrates a favourable balance of efficacy and safety compared with fentanyl and remifentanil.</jats:p>