The Comparison Of The Quality Of Recovery From General Anesthesia With Sufentanil And Remifentanil

Objective : Discussion of comparing the quality of recovery from anesthesia by with sufentanil and remifentanil, to choose a safer and more reasonable method of clinical anesthesia.Methods : Select forty patients of department of gynecology , ASAI-II ,age 20-50 years old, weighing 45-65 kg, about 3 hours of anesthesia time, blood loss less than 500 ml. Patients with no previous serious cardiovascular and cerebrov- ascular disease,no serious liver and kidney dysfunction, no long-term use of opioids or benzodiazepines drug history were randomely divided into two groups of 20 patients:group R (remifentanil) and S (sufentanil).Anesthesia of the two groups were induced with remifentanil 1ug/kg or sufentanil 0.35ug/kg and midazolam 0.05mg/kg,vecuronium 0.lmg/kg,propofol 1.5 mg/kg. Anesthesia of the two groups were maintained by TCI pump: R group was maintained with remifentanil 2-6ng/ml combined with propofol 2-3ug/ml; S group was maintained after induction with sufentanil 0.4-0.6ng /ml combined with propofol 2-3ug/ml. 30 minutes before the end of surgery, S group stopped the infusion of sufentanil. The infusion of remifentanil and propofol were stopped after surgery termination. According to CSI to adjust th speed of infusion , the CSI was maintained between 40 ~ 60. Vecuronium was used accordingly. The following were recorded and compared between group R and S:①B P,HR at the following time:before anesthesia(T0), end of surgery(T1),reach the indication of traeheal extubation (T2),tracheal extubation(T3),1 minute after extubation(T4),5 minutes after extubation(T5), 10 minutes after extubation(T6),20 minutes after extubatio- n(T7);②The duration from termination of surgery to full recovery of spontaneou- sly breathing,eye opening,response to instruction and traeheal extubation;③Postoperative complications like chill,cough,nausea and vomiting,low SpO2,restlessness,lethargy, et al:④Ramsay score after operation;⑤VAS score at the following time:5 minutes after extubation,30 minutes after extubation,1 hour after extubation and 3hours after extubation;⑥Side effect of drugs;⑦A wareness during operation.Results :①SBP,DBP and HR at T2 and T3 in both groups were higher than those at T0;HR at T4,T5,T6,T7 in group S were lower than those in group R②There were no statistics difference of the duration from termination of surgery to full recovery of spontaneously breathing,eye opening,response to instruction and tracheal extubation between the two groups;③The incidence of postoperative restlessness and chill was lower in group S than that in group R;④The patients of firstgrade of Ramsay score were fewer in group S than in group R;⑤VAS scores at 5 minutes after extubation,30 minutes after extubation and 1 hour after extubation in group S were signifieantly lower than those in group R and fewer patients needed analgesic;⑥There was no statistics difference of side effect of drugs in both groups; There was no awareness during operation in bothgroups.Conclusions :1.Compared to remifentanil,sufentanil can provide a more stable hemodynamic environment and it can reduce the incidence of postoperative pain and restlessness,but the occurrence of respiratory depression still has to be guarded against.2.Compared to remifentanil,sufentanil does not prolong the duration from termination of surgery to eye opening and tracheal extubation.