The Clinical Observation Of Sufentanil Applied In General Anaesthesia

ObjectiveTo explore influence of sufentanil applied in general anaesthesia on hemodynamics during induction and intubation, and influence on recovery.Method50 patients scheduled for elective tympanoplasty surgery were divided into 2 groups, sufentanil(SF) and fentanil (F) by using a random table. On the patient's arrival in the operating room, a peripheral venous line was inserted for fluid and drug administration. Bispectral index analysis(BIS),systolic pressure(SP),diastolic pressureh(DP),heart rate(HR),systemic vascular resistence (SVR),cardiac output(CO),stroke volume(SV)were measured as the basic values. Induction of anesthesia was begun slowly with midazolam 2mg, group F fentanil 4ug/kg, gruop SF sufentanil 0.04ug/kg, propofol 1～2mg/kg. rocurium 0.6mg/kg was given on Loss of Consciousness(LOS). The following variables were recorded :1) the time and BIS of LOC, 2) SP/DP,HR,SVR,CO,SV after induction, at intubation and 1,3,5 minute after intubation.5 minute after intubation, sevoflurane was given at the concentration of 4%.the flux of oxygen was 2ml/min, ventilation was adjusted to maintain an end-tidal CO₂ concentration of 4～5%. if BP or HR decreased by 20% of preoperative values, atropine 0.3mg or ephedrine 6mg was administered, if BP or HR was increased by 20% of preoperative values, fentanil 100ug or sufentanil 10ug was administered. Lactated Ringer'S Solution administered was restricted to 10ml/kg.h. sevoflurane was stoped when the operation was finished. the flux of oxygen increased to 4ml/h. The times recorded included times for return of spontaneous ventilation, returm of consciosness, return of analepsia, and extubation.patiens were sent to PACU and the pain of patients was assessed by using a visual analog scale(VAS) ranging from 0 to 10. Next day, patient follow-up was done. Nausea,vomiting and the satisfaction to VAS were recordedResultThe 2 groups did not differ with respect to the time and BIS of LOC(P>0.05). SP/DP,CO,SV after induction were decreased compared preoperative values(p<0.05), and SVR was increased compared preoperative value(p<0.05) in 2 groups. In group SF, HR increased 1,3 minute after intubation (p<0.05) . SP/DP were significantly lower than basic values(p<0.05) at intubation and 5 minute after intabation. SV was significantly lower than basic value (p<0.05) at intubation and 1,3 minute after intabation. CO was significantly lower than basic value (p<0.05) at intubation and 5 minute after intabation. In group F , HR was significantly higher than preoperative values (p<0.05) 1,3,5 minute after intabation. SP/DP were lower than preoperative values (p<0.05) at intubation and 5 minute after intabation. there was no significant differences at other times. SV and CO were significantly lower than preoperative values (p<0.05) at intubation and 1,3,5 minute after intabation. HR in group F was significantly higher than that in group SF 3,5 minute after intubation (p<0.05), SV in group SF was higher than that in group F(p<0.05) 1,3,5 minute after intabation.CO in group SF was higher than in group F(p<0.05) 1,3 minute after intubation. The VAS in group SF was significantly lower than that in group F(p<0.05) at analepsia,1 hour,2 hour after surgery .The incidence of neasea and vomiting in group SF was not different with that in group F(P>0.05).ConclutionCompared to fentanil, sufentanil applied in general anesthesia has less influence on hemodynamics, and can blunt cardiovascular changes induced by intubation effiently.Patients may recover from anaesthesia quickly. Effect of analgesia is strong. The incidence of neasea and vomiting did not differ.