The Effects Of Sufentanil With Various Doses On The Bispectral Index And Narcotrend Index Under The Sevoflurane Anesthesia

Objective:To observe the effects of sulfentanil with various doses on the Bispectral index and Narcotrend index with and without nociceptive stimulus under the sevoflurane anesthesia,and analyze the mechanism,the extents,and the character of their influence.Methods:Eighty four ASAⅠ～Ⅱpatients undergoing gynecological operations were randomly divided into seven groups(A,B,C,D,E,F,G,n=12).All patients were induced with sevoflurane with the primary concentration of 8%.After the loss of conscience,rocuronium 0.6mg/kg was injected intravenous(in groups of B,C,D,sufentanil was used simultaneously with the doses of 0.25μg/kg,0.5μg/kg,1.0μg/kg respectively).When the end-tidal concentrations of sevoflurane were raised till 2.0MAC,maintain the depth of anesthesia for 2 minutes,the orotracheal intubation was carried out.After the observation for 3 minutes, the end-tidal concentrations of sevoflurane in groups of A,E,F,G were adjusted to 1.0MAC,after the maintenance of 1.0MAC sevoflurane for 15 minutes,sufentanil was injected in groups of E,F,G with the doses of 0.25μg/kg,0.5μg/kg,1.0μg/kg respectively.The observations were over 10 minutes after the sufentanil injection.The values of Bispectral index and the Narcotrend index were recorded continuously.Also,the changes of mean arterial pressure(MAP)and heart rate(HR) were recorded simultaneously.The timepoints of MAP and HR were preinduction,the loss of conscience,preorotracheal intubation,1 minutes and 3 minutes after the orotracheal intubation.Results:The values of MAP and HR in the groups of A,B,E,F and G were higher transiently than those before the orotracheal intubation(OTI)(P＜0.05) while had no significant changes in group C and in group D(P＞0.05).The values of Bispectral index and Narcotrend index in all groups after the induction were lower than those baselines(P＜0.05).The BIS values after OTI were higher compared with those pre-OTI in the groups of A,B,C,E,F and G(P＜0.05).The values of BIS were no remarkable changeable pre and post the OTI in group D (P＞0.05).The tendency of the BIS values rising was decreasing with the increasing doses about sufentanil before the OTI(P＜0.001).In all groups,the Narcotrend values kept stable during the OTI(P＞0.05).Under the sevoflurene anesthesia with the steady end-tidal concentration of 1.0MAC,the values of HR,BIS and Narcotrend were significant lower after the infection of sufentanil in the groups of E,F and G with various doses(P＜0.05),while the MAP values had no changes in those three groups(P＞0.05).The time and the degrees of maximal effects about sufentanil affecting the BIS and Narcotrend values were similar in those three groups(P＞0.05).In the groups of E,F and G,the maximal descendent degrees of BIS values were resemble to those of Narcotrend values(P＞0.05).In group A,the values of MAP,HR,BIS and Narcotrend were no changeable.Conclusions:(1) Under the sevoflurane anesthesia,without nociceptive,various doses of sufentanil reduced the values of BIS and Narcotrend index stimulus,strengthening the depth of anesthesia(sedation),and the extents of depth-strengthening is similar within all groups;(2)During the ototracheal intubation,Sufentanil decreased the tendency of the Bispectral index rising dose-dependently(prohibiting the stress reaction),and the values of BIS index were not changeable after the orotracheal intubation with the application of sufentanil 1.0μg/kg via vein;(3)Compared with the BIS index,the Narcotrend index was insensitive in the prediction of the reaction to the orotracheal intubation.