The Effect Of Esmolol And Low-dose Fentanyl On The BIS And NI Change To Orotracheal Intubation During Sevoflurane Anesthesia

Objective To investigate the effect of esmolol and low -dose fentanyl on the bispectral index(BIS) and Narcotrend index(NI) change to orotracheal intubation, which during sevoflurane anesthesia.Methods sixty patients,ASAⅠ-Ⅱ,scheduled for bythus surgery,were randomized into 3 groups(n=20 each):groupⅠcontrol(S); groupⅡlow dose fentanyl(E);groupⅢesmolol and low dose fentanyl(F).All the anesthesia was induced by sevoflurane in oxygen,with an end-tidal concentration maintained at 1 minimum alveolar anesthetic concentration(MAC).Infusion of saline (control group S),fentanyl(2μg/kg;fentanyl group E),or fentanyl(2μg/kg) and esmolol(bolus of 1 mg/kg then 0.25 mg·kg^-1·min^-1;fentanyl and esmolol group F) was started 7 min after the induction of anesthesia and was continued after the intubation.Tracheal intubation was performed 12 min after anesthesia induction. Heart rate(HR),mean arterial pressure(MAP),BIS and NI were measured non-invasively every minute.BIS,MAP and HR were recorded before induction, before intubation and 1,2,3,5 minute after intubation.Results There were no significant differences in HP,MAP,BIS or NI among three groups before intubation. After intubation,the hemodynamic response of group E and group F was more less than group S(P<0.05 or 0.01);there were no significant differences in BIS and NI between group E and group S,while the statistical significance differences exist between group F and group S(P<0.05 or 0.01);the HR,MAP and BIS of group F changed significantly less than group E(P<0.05),but there were no significant differences between their Narcotrend indexes.Conclusion 1.The sevoflurane (1MAC) alone can not induce the intubation totally exclude the hemodynamic response.2.Addition with esmolol can release the hemodynamic response better than low-dose fentanyl alone during the sevoflurane anesthesia intubation.3.Addition with esmolol can significantly release the change of BIS during the sevoflurane anesthesia intubation.