Clinical study on total intravenous anesthesia with sufentanil-profofol given by target-controlled infusion in neurosurgical operations

Abstract

Abstract: AIM:To evaluate the anesthetic effect and the safety of total intravenous anesthesia (TIVA) with sufentanil-profofol given by target-controlled infusion in neurosurgical operations and to compare with intravenous inhalational anesthesia. METHODS:30 patients scheduled for craniocerebral operations were randomly divided into 2 equal groups: the TCI group (target- controlled infusion anesthesia) and combined IV and inhalation anesthesia (control group). Patients in the TCI group were anesthetized by TIVA with target controlled infusion of sufentanil (0. 2-0. 6 ng/mL) and propofol(3 μg/mL). Patients in the control group were given disconnected IV injections of vecuronium bromide combined with inhalation of 1% -2% isoflurance. The spectral index (BIS), mean arterial blood pressure (MAP) and heart rate (HR) of the patients were recorded at eight time points:before induction (T₀), after induction (T₁), after tracheal intubation (T₂), scalp incision(T₃), skull opening (T₄), tumor resection(T₅), scalp closure (T₆), extubation (T₇). Recording the awakening time, extubation time, anesthesia adverse reaction, degree of vigilance (OAAS scores) and pain degree(VRS scores) immediately and 30 min after extubation. RESULTS:The values of BIS in patients of both groups were significantly decreased after the induction of anesthesia and were maintained among 40 to 60, there were no significant differences between two groups(P >0. 05). At the T1, T3, T4, T7 time point, changes of the MAP and HR were more stable in TCI group than those in control group. The awakening time and extubation time in TCI group was obviously shorter in than that in control group. The OAAS scores after extubation were higher and the VRS scores 30 min after extubation were lower in TCI group than those in control group (P <0. 05). The occurrences of postoperative nausea, vomiting and restlessness were more frequently observed in patients in the control group than those in the TCI group. CONCLUSION:Target controlled infusion with sufentanil and propofol for TIVA has advantages of stability in hemodynamics, rapid recovery, less complications, no air pollution and is suitable for neurosurgical operation.

Key words: sufentanil, propofoll, target controlled infusion, neurosurgical operation

CLC Number:

R614

JIN Li-da, JIANG Liu-ming, ZHAO Xi-yue, LIN Li-na. Clinical study on total intravenous anesthesia with sufentanil-profofol given by target-controlled infusion in neurosurgical operations[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(5): 572-576.

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