Efficacy of target-controlled infusion of sufentanil at different target effect-site concentrations combined with propofol for anesthesia in laparoscopic surgery / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the efficacy of target-controlled infusion (TCI) of sufentanil at different target effect-site concentrations combined with propofol for anesthesia in laparoscopic surgery.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either gender, aged 18-68 yr, with body mass index of 17.0-29.5 kg/m 2, scheduled for elective laparoscopic surgery under general anesthesia, were included in this study.Anesthesia was induced with sufentanil combined with propofol given by TCI.The patients were divided into 3 groups ( n=20 each) using the sealed envelope method: target effect-site concentration 0.08 ng/ml group (Ⅰ group), 0.10 ng/ml group (Ⅱ group) and 0.12 ng/ml group (Ⅲ group). Anesthesia was maintained as follows the target effect-site concentrations of sufentanil given by TCI were 0.08, 0.10, and 0.12 ng/ml in Ⅰ, Ⅱ, and Ⅲ groups, respectively, the target plasma concentration of propofol was adjusted, and the bispectral index value was maintained at 40-60, the fluctuation range of mean arterial pressure and heart rate was maintained not exceeding 20% of the baseline value, intermittent intravenous boluses of rocuronium was given when needed, and propofol and sufentanil TCI was stopped at the end of operation.The operation time, time for TCI, consumption of sufentanil and propofol, the number of cases used ephedrine and atropine during the period of anesthesia maintenance, time to eye opening at the end of operation and time of tracheal extubation, nausea and vomiting, muscle stiffness, shivering, agitation, respiratory depression and intraoperative awareness were recorded, and the number of cases used analgesics within 30 min and 30 min-24 h after operation was recorded. Results:Compared with group Ⅰ, the consumption of sufentanil was significantly increased in group Ⅲ, and the time to eye opening and extubation time were prolonged in Ⅱ and Ⅲ groups ( P<0.05). The consumption of sufentanil was significantly higher in group Ⅲ than in group Ⅱ( P<0.05). There was no significant difference in the other parameters among the three groups ( P>0.05). Conclusion:When combined with propofol for anesthesia in laparoscopic surgery, the recommended target effect-site concentration of sufentanil given by TCI is 0.08 ng/ml.