Efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectom / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectomy.Methods Twenty ASA I or II patients of both sexes aged 17-40 yr weighing 52-75 kg undergoing video-assisted endoscopic transthoracic sympathectomy were enrolled in this study.Anesthesia was induced with propofol 2.0-2.5 mg/kg and sufentanil 0.5 μg/kg.Tracheal intubation was facilitated with atracurium 0.6 mg/kg.The patients were mechanically ventilated (VT=8-10 ml/kg,RR=10-12 bpm,IE =12,FiO2=80%).Anesthesia was maintained with infusion of propofol 2-4 mg·kg-1·h-1 and sufentsnil 0.2-0.3/.μg·kg-1 h-1 and intermittent iv boluses of atracurium.At the 30 rain before the end of operation propofol infusion was reduced to 1-2 mg.kg-1·h-1 and sufentanil infusion to 0.1 μg·kg-1 h-1 .BP (SP,DP) and HR were recorded and venous blood samples were taken before induction of anesthesia (baseline),at tracheal intubation at the moment of CO2 insnfflation 10 min and 30 min after CO2 insufflation,5 min after deflation and at extubation for determination of plasma corticesteroid,aldosterone and glucose levels.The duration from termination of infusion of the anesthetics to recovery of spontaneous breathing,eye opening at command and tracheal extubation were recorded.Results SP,DP and HR were within the normal range.Plasma levels of comcesteroid,aldosterone and blood glucose were significantly increased during operation as compared with the baseline values.The duration from termination of infusion of the anesthetics to recovery of spontaneous breathing,eye opening at command and tracheal extubation were4.5±1.9,6.4±2.7 and (12.6±1.5)min respectively.Conclusion Sufentanil 0.1-0.3 μ·kg-1·h-1 combined with propofol 1-4 mg·kg-1.h-1 can inhibit stress response during video-assisted endoscopic transthoracic sympathectomy with stable hemodynamics.