Comparision Of Sufentanil And Fentanyl On Hemodynamics And Recovery Phase In Patients For Neurosurgical Surgery

To study the effect of using sufentanil on hemodynamics and recovery phase from general anesthesia on patients undergoing intracranial surgery,and to provide reference for clinical medication.Methods:45 ASAâ… -â…¡patients scheduled for intracranial surgery were randomly divided into three groups:fentanyl group(F,n=15), sufentanilâ… group (SFâ… ,n=15),sufentanilâ…¡group (SFâ…¡,n=15). All patients were induced with midazolam 0.1mg/kg,fentanyl 5ug/kg (groupF),or sufentanilâ… lug/kg(groupSFâ… ),sufentanil0.5ug/kg (group SFâ… ),vecuronium 0.1 mg/kg, etomidate 0.3mg/kg. Tracheal intubation was performed after five minutes of induction. Sevoflurane was inhaled at the concentration of 1-1.5MAC,followed by continuous intravenous pumping of propofol (5-8mg/kg/h) and fentanyl 3ug/kg/h,sufentanil 0.6ug/kg/h(groupSFâ…¡)or sufentanil 0.3ug/kg/h (groupSFâ…¡).Vecuronium 2mg was injected at the interval of 30 minutes. Sevoflurane,fentanyl or sufentanil were stopped after the endocranium closure and propofol was stopped when the operation was finished. The changes hemodynamics were continuously monitored and recorded at different time points.The timepoints setting for observation were:the baseline values(TO),1,3,5min after induction,1,3,5min afer tracheal intubation, skin incisions,during tracheal extubation,1,3,5min after tracheal extubation. Radial arterial blood sampling were underwent to detect the concentration of blood glucose(BG).The time to recovery of spontaneous breath,opening eyes and extubation after the operation were recorded. Evaluating the recovery profiles from general anesthesia with the grade of Steward.The incidence of adverse reactions were recorded.Results:The baseline values on HR, MAP and blood glucose(BG) from the three groups were similar. In group F, the MAP at 3min,5min after anesthesia induction were lower than the baseline values (P< 0.01). The MAP from group F on 1min after endotracheal intubation, tracheal extutation and lmin after tracheal extubation were higher than the baseline value and group SF(P<0.05). The HR. from group SFâ…¡3min after induction,5min after endotracheal intubation were lower than the baseline values(P<0.01),and the MAP after endotracheal intubation were lower than the baseline values (P< 0.05). The extubation time and the consciousness time were shorter in group SF than those in group F(P<0.05),the extubation time were shorter in group SFâ…¡than those in group SFâ… (P<0.05).The postoperative complications in these groups were similar(P>0.05). The Steward scores at 5min,15min after extubation, group SF were lower than group F(P<0.05). The BG from group F were higher than group SF.Conclusions:Using sufentanil is superior to using fentanyl in general anesthesia of intracranial surgery. Compared to using fentanyl, the anesthesia induction and maintenance are more stable, and the quality of consciousness is better by the use of sufentanil. The effect of using the low dose of sufentanil(induce dose0.5ug/kg,maintenance dose0.3ug/kg/h) is superior to using the large dose (induce dose:1ug/kg,maintenance dose:0.6ug/kg/h).