Anesthetic efficacy comparison of fentanyl and sufentanil in vocal cord tumors excision in elderly patients / 肿瘤研究与临床

ABSTRACT

Objective To compare the anesthetic effect of fentanyl and sufentanil in vocal cord tumors excision in elderly patients.Methods Sixty elderly patients from the First Hospital of Shanxi Medical University scheduled for elective excision of vocal cord tumors were randomly divided into fentanyl group (group F) and sufentanil group(group SF) according to the random number table method, and each group had 30 cases. The dose was determined by its efficiency ratio of analgesic (10:1) followed by anesthesia induction with compound etomidate and cisatracurium. Besides, injection remifentanil and propofol with pump was used for anesthesia maintenance during the operation. Haemodynamics indicators of group F and group SF were recorded at different time point, including before (T0), after induction of anesthesia (T1), immediately after intubation (T2), during the resection of tumor (T3), before extubation (T4) and after extubation (T5). Time to resuscitation, time to extubation, the cooperation at extubation, the sedation scores of 10 minutes after extubation (according to Ramsay sedation level score), and the complications of anesthesia were recorded respectively. Results In the group SF, T0pressure: (135±6) mmHg / (82±6) mmHg (1 mmHg = 0.133 kPa), heart rate:(80±7)/min;in the group F,T0pressure:(129±7)mmHg/(79±6)mmHg,heart rate:(80±7)/min.In the group SF,T1pressure:(102±5)mmHg/(61±4)mmHg,heart rate:(64±4)/min;in the group F,T1pressure:(100±6) mmHg / (61±4) mmHg, heart rate: (61±3) /min. T3heart rate: (89±5) /min (group SF), (92±5) /min (group F). Compared with T0, the pressure and heart rate of T1were decreased in both groups, and the heart rate of T3was increased (P < 0.05). The time to resuscitation and time to extubation in the group F was shorter than that in the group SF[(5.5±1.8)min vs.(10.4±3.1)min,(8.6±2.4)min vs.(15.4±2.6)min,both P<0.05].Ramsay score in the group F was lower than that in the group SF[(2.4±0.3) scores vs. (3.2±0.5) scores, P<0.05]. There were no significant differences in the cooperation at extubation, incidence rate of vomiting and nausea between the two groups (all P > 0.05). Intraoperative awareness and postoperative irritability were not found in both groups.Conclusions The equivalent dose of fentanyl and sufentanil induction are safe and effective for elderly patients with excision of vocal cord tumors. The patients can get more rapid revival and higher revival quality after fentanyl induction.