Effects Of Different Doses Of Sufentanil On Cardiovascular Response To Rapid Sequence Induction And Intubation

Objective:In full stomach patients under general anesthesia,rapid sequence induction and intubation(RSII)could increase heart rate(HR)and blood pressure(BP).In this study,HR,BP and transthoracic echocardiography were used to evaluate the effects of different doses of sufentanil on the cardiovascular response to RSII,in order to provide drug options for reducing adverse cardiovascular response to RSII.Methods:80 patients were randomly divided into four groups:normal saline group(NS group),0.1ug/kg sufentanil group(S0.1 group),0.2ug/kg sufentanil group(S0.2 group)and 0.3ug/kg sufentanil group(S0.3 group).Rapid sequence induction was performed with 2.5mg/kg propofol and 0.9mg/kg rocuronium.HR,mean arterial pressure(MAP),ejection fraction(EF),stroke volume(SV)and cardiac output(CO)were recorded before induction(T0),1min(T1),3min(T3)and 5min(T5)after intubation.General data,OAA/S score,SpO2 change,cormack-lehane grade,intubation time and intubation conditions were recorded among the four groups.Results:73 patients were included in the final analysis.There was no difference in general data between groups(P>0.05).Compared with the T0,MAP,EF and SV were increased in NS,S0.1 and S0.2 group at T1(P<0.05),while MAP,EF and SV did not change significantly in S0.3 group(P>0.05),in all four groups HR and CO were increased at T1(P<0.05),MAP,EF and SV were decreased in S0.3 group at T3 and T5(P<0.05);Compared with T1,HR,MAP,EF,SV and CO were decreased among four groups at T3 and T5(P<0.05);Compared with T3,HR,MAP,EF,SV and CO were decreased among four groups at T5(P<0.05).There was no difference in HR,MAP,EF,SV and CO among four groups at T0(P>0.05);HR,MAP and CO in the S0.2 group and S0.3 group were significantly lower than those in the NS group at T1 and T3(P<0.05),and HR and MAP in the S0.2 group and S0.3 group were significantly lower than those in S0.1 group at T1 and T3(P<0.05);There was no difference in EF and SV among four groups at T0,T1,T3 and T5(P>0.05).OAA/S score in NS group was significantly higher than that in S0.1,S0.2 and S0.3 group(P<0.05),while OAA/S score in S0.1 and S0.2 group was significantly higher than that in S0.3 group(P<0.05);There was no difference between four groups in SpO2,cormack-lehane grade and intubation time(P>0.05);The intubation condition in S0.3 group was significantly better than that of NS and S0.1 group(P<0.05).Conclusions:Pre-injection of sufentanil can alleviate the cardiovascular response during rapid sequence induction and intubation with propofol 2.5 mg/kg and rocuronium 0.9 mg/kg,with 0.3 μg/kg sufentanil as the optimal dose.