Effects of different doses of sufentanil and remifentanil combined with propofol in target-controlled infusion on stress reaction in elderly patients

Abstract

The current study aimed to observe the effects of sufentanil and remifentanil combined with propofol in target-controlled infusion (TCI) on perioperative stress reaction in elderly patients. A total of 80 elderly patients requiring general anesthesia were recruited. They were divided into four groups (each n=20) according to different target concentrations of remifentanil and sufentanil. These target concentrations were: 4 ng/ml remifentanil + 0.2 ng/ml sufentanil for group I; 3 ng/ml remifentanil + 0.3 ng/ml sufentanil for group II; 2 ng/ml remifentanil + 0.5 ng/ml sufentanil for anesthesia induction and post-intubation 3 ng/ml remifentanil + 0.2 ng/ml sufentanil for anesthesia maintenance for group III; and 5 ng/ml remifentanil for anesthesia induction and post-intubation 4 ng/ml remifentanil for anesthesia maintenance for group IV. Norepinephrine (NE), epinephrine (E) and angiotensin II (Ang II) levels in plasma were measured prior to the induction of anesthesia, as well as at several different time-points following surgery. The numbers of intraoperative severe hemodynamic fluctuation, postoperative eye-opening and extubation time, and post-extubation restlessness and pain scores were recorded. Group IV had a larger circulation fluctuation control number and higher levels of NE, E and Ang II at 3 h after surgery than any other group (P<0.01). Although group IV had shorter postoperative eye-opening and extubation times compared with the other groups (P<0.05), it also had higher restlessness and pain scores (P<0.01). The combined use of sufentanil and remifentanil stabilizes perioperative hemodynamics and reduces stress hormone levels.

Comparison of recovery effect for sufentanil and remifentanil anesthesia with TCI in laparoscopic radical resection during colorectal cancer

“…Stress response is a non-specific defense reaction that occurs in the human body when externally stimulated. Previous findings ( 2 , 17 , 18 ) have shown that, stress responses initiated from anesthesia and surgery occur during the perioperative period, with a certain impact on recovery of patients following surgery. Serum COR and blood GLU can reflect t the intensity of stress response in the human body and IL-6 and IL-10 are important cytokines that are involved in the inflammatory response and injury repair and reflect the degree of human stress ( 19 ).…”

“…Sufentanil is a type of narcotic drug and opioid receptor agonist, and contains citrate as the main pharmacological component ( 2 – 4 ). Sufentanil is easily transferred through the blood-brain barrier with its high lipid solubility, and can bind with plasma protein for a good analgesic effect, with a longer interval for anesthesia ( 12 , 13 ).…”

“…Colorectal cancer is one of the most common types of digestive tract tumors affecting 1.23 million individuals per year (9.7% of overall cancers) and is the fourth most common cause of mortality from cancer worldwide (608,000 cases, 8% of overall cancer deaths) ( 1 ). Currently, laparoscopic radical resection is the most widely used clinical treatment for colorectal cancer, however, it causes great discomfort for the patient ( 2 ). To improve the quality of anesthesia in the laparoscopic radical resection of colorectal cancer is a challenge for the medical field ( 3 , 4 ).…”

Comparative effects of target-controlled infusion of anesthetic sufentanil and remifentanil on inflammatory factors and oxidative stress indicators in patients of colorectal cancer

“…Sufentanil is a strong analgesic drug, and can be used repeatedly; in addition, it does not produce accumulation effect and thereby the impact on the cardiovascular system is weak. 7 Anesthesia and surgery can cause intense stress response and in stress stimulation of surgery and tumor; the patients will release a large number of inflammatory factors which have important influence on the therapeutic effect and prognosis of surgery. Previous studies show that the mechanism of systemic inflammatory response caused by surgery is very complex.…”

Effective Target Concentration of Sufentanil Combined With Sevoflurane Anesthesia for Abdominal Surgery: A Dose-Response Study

“…use of TCI enables the efficient, safe, and stable administration of sufentanil. 19,20 Combined administration of inhaled anesthetics and sufentanil has been widely used. Meaudre et al 21 found that 0.30 lg/kg sufentanil supplementation of sevoflurane during induction of anesthesia resulted in a better quality of induction without significant cardiovascular depression.…”