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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2000 November;66(11):787-91


language: Italian

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.

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