Comparative study of sufentanil and fentanyl for anesthesia in neurosurgical procedure

Abstract

Objective To compare the effects of sufentanil and fentanyl as general anesthesia on hemodynamics, recovery profiles and the stress reaction at perioperative period in patients undergoing intracranial tumor resection. Methods A total of 50 patients scheduled were randomized to receive sufentanil (group S, n = 25) or fentanyl (group F, n = 25) as general anesthesia for intracranial tumor resection. Sufentanil was performed in group S by combination of intravenous propofol and sevoflurane anesthesia, while fentanyl plus propofol continuous intravenous infusion was used in group F followed by sevoflurane anesthesia. The patients' mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) were continuously monitored and recorded at different time points including baseline (T0), postanesthesia induction (T1), 1 min after endotracheal intubation (T2), head holder application (T3), skin and dural incisions (T4, T5), dural closure (T6), spontaneous breath recovery (T7) and after endotracheal extubation (T8). Blood glucose and epinephrine were determined before and after anesthesia induction. Results In both groups, the HR at T5, T7 and T8 were higher than baseline value (P < 0.05, for all), and MAP decreased at T1, T5 and T6 (P < 0.05, for all). Increased MAP was seen in group F during T4 and T8 (P < 0.05, for all). MAP and HR were all higher in group F than those in group S during operation at different monitoring times (P < 0.05 or P < 0.01). Autonomous respiration recovery and endotracheal extubation were all earlier in group S than group F (P < 0.05, for all). There were no significant differences of blood glucose and epinephrine at preoperation, skin incision 30 min and extubation (P > 0.05, for all). Conclusion Compared to fentanyl, hemodynamics is more stable at different anesthetic periods, and cardiovascular reaction is more mild in endotracheal intubation by using sufentanil as anesthesia. Neither fentanyl nor sufentanil obviously effects blood glucose and epinephrine at perioperative period.

DOI：10.3969/j.issn.1672-6731.2010.04.010