Background and Objectives; Sufentanil is a potent opioid that offers favorable pharmacological properties for use in total Intavenous Anaesthesia (TIVA). Numerous protocols of delivery of sufentanil infusion have been described but each shows different hemodynamic response as well as recovery time. It is a short acting opioid with high hepatic clearence and has synergistic activity with propofol. This study was done to evolve an infusion protocol that bpermits adequate anaesthetic depth along with rapid recovery, while avoiding or minimizing the side effects of this potent drug in day care surgery. Materials and methods: The study was a prospective, randomized, controlled study carried out at command Hospital Air Force, Bangalore after hospital ethical committee approval, 60 adult patients were studied. These patients were then allocated randomly into a group A and group B of 30 each by picking up chits labeled A and B. All the patients received general anaesthesia. The patients were monitored at pre-induction, post induction, 1 minute after intubation and every three minute there after. Anesthesia was induced by propofol infusion with a bolus of 1.5 mg/kg followed by an infusion @140 mcg/kg/min for 10 minutes and @ 50mcg/kg/min there after. Six minutes after propofol infusion (@140mcg/kg/min), sufentanil was started. In group A,a bolus of 0.1 mcg/kg of sufentanil was administered and followed by an infusion of 0.3 mcg/kg/h of sufentanil. In group B Patients were given a bolus of 0.25 mcg/kg of sufentanil followed by an infusion of 0.1 mcg/kg/h of sufentanil as per protocol. Orotracheal intubation in both groups was facilitated by Inj succinylcholine 1.5 mg/kg IV. After confirmation of endotracheal tube placement, vecuronium (0.05 mg/kg ) was administered to provide muscle relaxation during surgical procedure. Patients lungs were ventilated with 30% of oxygen in nitrous oxide.
patients were reversed with Injection Neostigmine 50 mcg/kg and Inj Glycopyrolate 10 mcg/kg IV. Patients were observed for recovery time from anaesthesia and were assessed on the basis of modified post anaesthesia discharge scoring system (MPDSS). The time taken to satisfy discharge criteria was considered as recovery time and was compared with two groups. Result: Our result showed that the haemodynamic changes were better controled in group B patient compare to Group A patients and are highly significant with p<
0.001. the recovery from anaesthesia was better in-Group B compare to Group A and is highly significant (p<0.0001) Conclusion: Our study concluded that sufentanil 0.25 mcg/kg/ IV as a bolus after induction with propofol effectively controls responses to tracheal intubation. After tracheal intubation in the subsequent perioperative period, sufentanil either as0.1 mcg/kg/hr infusion or as a0.3 mcg/kg/hr infusion IV with propofol infusion @ 50mcg/kg/min was equally effective to control intraoperative responses. Emergence from anaesthesia was however more rapid when an infusion rate of 0.1 mcg/kg/hr infusion was used when compare to an infusion rate of 0.3 mcg/kg/hr
Impact Factor
2022: 6.012
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