Anesthesiology Journal's podcast Featured Author Podcast: Fentanyl Ventilatory Depression
Oct 22, 2025
Rutger van der Schrier, M.D., Ph.D., a postdoctoral scholar at Leiden University, and Steven L. Shafer, M.D., a professor emeritus of anesthesiology, dive into fentanyl's impact on ventilation. They discuss how fentanyl's ventilatory depression is complicated by individual variability and environmental factors, revealing surprising insights from their study on healthy volunteers. The conversation explores ethical concerns, opioid receptor complexities, and innovative modeling techniques to predict respiratory effects. A must-listen for anyone interested in opioid pharmacology!
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Isolating Fentanyl's True Effect
- Fentanyl's true ventilatory effect is best measured in healthy volunteers without other anesthetics or pain influences.
- Modeling CO2 feedback yields more clinically relevant potency estimates than simple measures.
The Double-Edged Nature Of Opioids
- Opioids cause many adverse effects including respiratory depression and high addiction potential.
- Their unmatched analgesic efficacy explains continued clinical reliance despite toxicity.
Use Realistic Intraoperative Dosing
- Mirror typical intraoperative dosing when studying opioid effects to improve relevance.
- Use an initial larger dose with smaller top-ups while monitoring continuously for safety.