Comparison Of The Same Effectively Dose Sufentanil And Fentanyl The Prevention Postanesthetic Shivering

IntroductionThe postanesthesia shivering refers that a set of mucsle or lots of sets ofmuscles happen to active without motion after the early general anesthesia ,they aredivided into two kinds ,the one is physical to low temperature during theoperate ,the other is not adjusted temperature shivering as usually skin arteryopening. The data of epidemiological investigation showed that the incidence rate ofadults was 5%-65% ,the postanesthetic shivering results in expensiture oxygenincreasing about 500% .Especially ,it is more dangerous for the patients of lung orcoronary heart disease.At present there are many methods to theraphy postanestheticshivering ,including the drugs way and no drug way .Though it can reduce theincidence rate of postanesthetic shivering to some degree ,what works slowly whenhanppening postanesthetic shivering makes itself limited. Sufentanil is a new drugin the clinical in the early years ,there is a lot of advantages for the clinical ,such aspulling out drainage tube and tracheal catheter by oneself ,and haemorrhage from theoperative site ,and so on.Many reports concern about shivering after general anaesthsia with tramadoland dolatine ,but little about sufentanil and fentanyl .Our study aim at comparing theincidence rate of shivering during analepsia time with the two general anaesthesiadrugs and to provide the basement of theory to select reasonable dinicol anesthetildrugs. Materials1 Patients:Nity patients scheduled for redical operation of mastocarcinoma andtympanoplasty procedure ASAâ… -â…¡,whose age were from 28 to 65 ,were selectedwithout sex limitation. All patients had no important organ dysfunction ,and nohistory of excessive drinking ,drug taking ,drug abuse and mental disease.2 main drugs:Propofol (AstraZeneca Pharmaceutical Limited Company);Sufentanil (Hubei Yichang Renfu pharmaceutical Limited Company);Fentanyl (Hubei Yichang Renfu pharmaceutical Limited Company);Midazolam (Jiangshu Enhua pharmaceutical Limited Company);Vecuronium (N.V.Organon).3 Main apparatus: All-round anaesthetic machine (Detax Ohmeda7000American);Multifunction monitor (Detax Ohmeda S/5 American);intravenoustransfusion pump (B.Braun micro-injection pump Germany); Datexe anesthesiagas monitor.Methods1 Grouping:40 patients under general anesthesia were randomly divided into twogroups. Sufentanil combination group (S group n=20);and fentanyl combination group(F group n=20).2 Anesthesia method(1) Premedication of atropine 0.5mg was intramuscularly administered 30minutes before operation All patients were monitored with continuouselectrocardiograph ,Anesthesia induction consisted of intravenous midazolam0.04mg/kg,vecuronium0.1 mg/kg ,propofol 2mg/kg,fentanyl 5μg/kg ,Afterintroduction ,tracheal intubation was performed and mechanical ventilation wereoperated.(2) In the S group the continuous intravenous infusion of sufentanil at the dose of 0.5μg/kg were given .In the F group the continuous intravenous infusion offentanyl at the of 5μg/kg .In the two groups the continuous infusion of propofol at thedose of 4μg/ml .and P_ETCO₂ was 30-35mmHg .Based on the demand ofoperation ,vecuronium was intermitted intravenous injected .Intravenous infusion ofsufentanil and fentanyl were stopped 30 minutes before the end of operation ,In the Sand F groups were stopped at once in the end of operation .After the spontaneousbreath and recovered ,and SPO₂≧95% when breath in the air ,muscle powerrecovered ,the tracheal catheter was pulled out.3.Monitor index: The incidence rate of shivering ,the time of getting out theoperating room and the time of extubating were observed .The mean arterial bloodpressure (MAP),heart rate (HR) ,SpO₂ and temperature value were recorded beforethe anesthesia induction, after the tracheal catheter was pulled out 1 minute ,5minute, 10 minute ,20 minute ,at the end of operation ,and the happening of shiveringand the relieving of shivering .The score of shivering was recordedResults1 General state :There were no significant difference of operation time ,sexratio ,age ,height ,temperature ,anesthesia time and operation time (P＞0.05).2 The incidence of shivering: Group S was 5% and Group F was 30% during therecovery time ,there were very significant difference between Group S andGroup F (P＜0.05) .There was only one patient having 2 score in Group S andthere were two patients having 1 score ,three patients having 2 score and onepatient having 3 score.3 The mean arterial blood pressure (MAP) ,heart rate (HR) ,SpO₂ :After the trachealcatheter was pulled out 1 minute ,MAP of Group S vary significantly comparedto Group F(P＜0.05) ,in the Group S there were no significant difference betweenintroduction and tracheal catheter 1 minute(P＞0.05) ,in the Group F there werevary significantly difference between introduction and tracheal catheter 1 minute (P＜0.05).4 Extubation time and out-room time :extubation time and out-room time werevary significant difference between Group S and Group F (P＜0.05) ,after theoperation VAS score Group F was much higher than Group S (P＜0.05),and needtramadol in Group F was more than Group S (P＜0.05).ConclusionCompared to the same does fentanyl ,sufentanil can effectively decreaseshivering after anesthesia ,especially ,it is more safety for the patients of lung orcoronary heart disease to use sufentanil to prevent the postanesthetic shivering.