Effective Bolus Dose of Sufentanil to Attenuate Cardiovascular Responses in Laryngoscopic Double-Lumen Endobronchial Intubation

Abstract

BackgroundSufentanil is a potent opioid analgesic frequently used in clinical anesthesia. Double-lumen endobronchial intubation induces profound cardiovascular responses in comparison with ordinary endotracheal intubation because of the larger tube diameter and direct irritation of the carina.ObjectivesThe purpose of this study was to determine the effective bolus dose of sufentanil to attenuate hemodynamic changes in response to laryngoscopic double-lumen endobronchial intubation.Patients and MethodsWe randomly assigned 72 patients aged 18 - 65 years and with an American Society of Anesthesiologists physical status of 1 or 2 to one of four sufentanil dose groups: NS, S0.1, S0.2, or S0.3. The respective doses for the groups were as follows: normal saline, 0.1 mcg/kg of sufentanil, 0.2 mcg/kg of sufentanil, and 0.3 mcg/kg of sufentanil. Blood pressure and heart rate were recorded during the pre-anesthesia period at baseline, pre-intubation, immediate post-intubation, and every minute during 5 minutes after intubation.ResultsBaseline mean arterial pressures in the NS, S0.1, S0.2, and S0.3 groups were 89.8 ± 12.1, 89.2 ± 10.9, 88.8 ± 13.6, and 90.7 ± 11.1, respectively. At immediate post-intubation, the mean arterial pressures in the NS, S0.1, S0.2, and S0.3 groups were 129.7 ± 14.7, 120.7 ± 14.2, 120.8 ± 17.2, and 96.7 ± 10.4, respectively. At immediate post-intubation, the mean arterial pressure in the NS, S0.1, and S0.2 groups significantly increased from baseline (P < 0.001), but the S0.3 group showed no difference. In the time point comparison at immediate post- intubation, the S0.3 group had a significantly lower mean arterial pressure than did the NS, S0.1, and S0.2 groups (P < 0.001).ConclusionsWe found that 0.3 mcg/kg of sufentanil attenuates cardiovascular responses to double-lumen endobronchial intubation without adverse effects.

Comparison of the effect of different infusion rates of sufentanil on surgical stress index during cranial pinning in children under general anaesthesia: a randomized controlled study

“…In our study, BP changed with the cranial pinning stimulus, demonstrating an increase at 1 and 2 min after cranial pinning in all groups; subsequently, BP decreased. Importantly, this finding was consistent with a previous study [ 20 ]. However, SSI did not follow this trend, thereby demonstrating that SSI measurements and traditional clinical findings were quite disparate.…”

Preemptive Anti–Stress Response Effects of Oxycodone Versus Sufentanil for Patients Undergoing Cardiac Valve Replacement—A Randomized Controlled Trial

“…Sufentanil is commonly used in cardiac surgery for anti‐stress response, which has the advantages of quick onset, long duration and potent analgesic effect. Research found that sufentanil attenuated cardiovascular responses during period of double‐lumen endobronchial intubation . However, the use of sufentanil followed with some un‐ignored adverse reactions, such as respiratory depression, a significant clinical problem .…”

“…Research found that sufentanil attenuated cardiovascular responses during period of double-lumen endobronchial intubation. 21 However, the use of sufentanil followed with some un-ignored adverse reactions, such as respiratory depression, a significant clinical problem. 22 Oxycodone is an opioid μand κ-receptor agonist and widely used for mild and severe pain controlling.…”

Bradyarrhythmia and hypotension during anesthetic induction—reconsideration of nifedipine: a case report

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