The Clinical Observation Of Sufentanil Applied In Anesthesia Induction Of The Elderly Hypertention Patients

objective To explore influence of sufentanil applied in general anaesthesia on hemodynamics during induction and intubation of the elderly hypertention patients.Method 36 ASA gradeⅡpatients, scheduled for elective abdominal operations, were randomly divided into 2 groups. Group sufentanil(Suf): combining sufentanil with etomidate; group fentnyl(F): combining fentanyl with etomidate. On the patients'arrival in the operating room, a perpheral venous line was inserted for fluid and drug administration. Systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR), mean arterial blood pressure (MAP) were measured as the basic values(T0). Induction of anesthesia was begun slowly with midazolam 0.05 mg.kg-1, group F fentanil 3μg.kg-1, group SF sufentanil 0.5μg.kg-1, vecuronium 0.1 mg.kg-1 was given on loss of consciousness (LOS) ,then etomidate 0.2 mg.kg-1 . After 3 minutes, tracheal intubation was successfully performed within 30 seconds.The following variables were recorded: SBP, DBP, MAP, HR at T1(postinduction values or immediately before intubation) and 1(T2), 3(T3), 5(T4) minute after intubation. 5 minute after intubation , Isoflurane was given at the concentration of 1～2%. Ventilation was adjusted to maintain an end-tidal CO2 concentration of 35～45mmHg. If BP or HR decreased by 30% of preoperative values, atropine 0.2mg or ephedrine 5mg was administered; If BP or HR was increased by 30% of preoperative values etomidate 0.2 mg.kg-1 was administered.Result The difference in patients'age, bodyweight, sex and basal blood pressure, heart rate is of no statistical significance between the two groups.MAP and HR decreased dramatically at T1 compared to T0 in both sufentanil group and fentanyl group (P<0.05), but there are no difference between two groups (P >0.05). MAP, HR in l, 3, 5 minute after intubation compared to T1 were all increased significantly (P<0.05) in both sufentanil group and fentanyl group, in group F the differences between the values of 1, 3, 5 minute after intubation and T1 (postinduction values)were higher than those in group Suf (P<0.05).SBP and DBP decreased dramatically at T1 compared to T0 in both sufentanil group and fentanyl group (P<0.01), but there are no difference between two groups (P > 0.05). Tracheal intubation caused significant increases in SBP and DBP in both sufentanil group and fentanyl group compared with postinduction values (immediately before intubation) (P<0.05). In group F the differences of SBP between the values of 1, 3minute after intubation and T1 (immediately before intubation)were higher than those in group Suf(P<0.05); The difference of SBP between the values of 5 minute after intubation and T1 (immediately before intubation) is of no statistical significance between group F and group SuF. In group F the differences of DBP between the values of 1 minute after intubation and T1 (immediately before intubation)were higher than those in group Suf(P<0.05), there was no significant differences at other times.Conclusion sufentanil applied to induction and intubation of the elderly hypertention patients is more effective in attenuating the cardiovascular intubation response than fentanyl.