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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTESIOLOGY
Minerva Anestesiologica 2000 November;66(11):787-91
Sufentanyl in balanced anesthesia for neurosurgery. Comparative study with fentanyl
Cafiero T., Mastronardi P. *
Ospedale «San Rocco», Sessa Aurunca, ASL CE/2 Servizio di Anestesia e Rianimazione
*Università degli Studi «Federico II» - Napoli Dipartimento SCARE
Background. The aim of this study was to evaluate the effects of sufentanil in comparison with those of fentanyl during balanced anesthesia in patients undergoing neurosurgery.
Methods. Experimental design: prospective randomized study. Setting: operating room in a neurosurgery University department. Patients: 50 patients, ASA I and II with age ranging from 18 to 77 years were divided in two groups randomly. Interventions: 25 patients received sufentanil as single bolus dose of 0.2 µg/kg i.v. as premedication and supplemental bolus doses of 0.15 µg/kg during the maintenance of anesthesia while the remainders received fentanyl 2.0 µg/kg as premedication and supplemental boluses of 1.5 µg/kg. All patients were induced with propofol 2.5 mg/kg, were intubated after cisatracurium 0.15 mg/kg for muscle relaxation, then were ventilated with sevoflurane and O2:N2O (1:1). Measurements: heart rate, SAP, DAP and MAP were recorded at different times and ECG, ETCO2 and pulsoximetry were monitored continuously. Furthermore postoperative analgesia by VAS, recovery time and inspiratory concentrations of the volatile anesthetic were evaluated. Statistical analysis was carried out using ANOVA for repeated measures and Bonferroni “t”-test; a value of p<0.05 was considered to be significant.
Results. Significant changes in MAP (at IOT and 1 and 2 min after IOT), in HR (at IOT) and in RPP (at IOT and 1, 2 and 3 min after IOT) were recorded in group F. Recovery time was shorter in group S than in group F and postoperative analgesia was more prolonged in group S. Inspiratory concentrations of volatile agent were lower in patients treated with sufentanil than in those treated with fentanyl.
Conclusions. In patients treated with sufentanil a better cardiocirculatory stability was achieved with lower inspiratory concentrations of volatile agent and a well relaxed brain. Sufentanil can be considered a valid alternative to fentanyl as analgesic agent in balanced anesthesia for neurosurgery.