Sufentanil combined with propofol by target-controlled infusion for patients with liver dysfunction during induction of anesthesia

Objective To evaluate the feasibility and safety of target-controlled infusion of sufentanil combined with propofol for patients with liver dysfunction during induction of anesthesia,to explore suitable sufentanil concentration,as well as the effect of different concentrations of sufentanil on pharmacodynamics of propofol to target-controlled infusion (TCI).Methods Thirty patiens were recruited in the study,who were ASA physical status Ⅱ～Ⅲ and child-B undergoing splenectomy plus porta-azygosdisconnection.Candidates were dicided into two groups the concentrations of Sufentanil,which were target-controlled infusion with Ce value at 0.6 μg/L (L group) and 0.8 μg/L (H group) during induction of anesthesia.Target-controlled infusion of Propofol started when the Ce of sufentanil reached.When patients lost their awareness,the Cp of propofol was adjusted lower which would make Ce higher than Ce of unawareness.At the same time the tracheal intubation was facilited with rocuronium 0.9mg/kg.Record the value of different times.Results In L group there were no obvious fluctuations in HR and MAP.The MAP rised 4.2% than the basic value in H group when Ce value of sufentanil reached 0.8 μg/L (P 0.05).Three cases of respiratory depression ventilatory and four cases of muscular stiffness could be observed in H group,the difference bentween L and H group was signigicant (P 0.05).In both groups,the BIS value did not change significant before and after infusion of sufentanil (P 0.05).There were singnificant differences in Ce of Propofol between two groups [(1.84±0.54) mg/L and (1.32±0.37)mg/L in group L and H,respectively]at the time of unconciousness (P 0.01).There were singnificant differences in dosages of Propofol between two groups [(62.24±6.03) mg and (39.83±5.64)mg in group L and H,respectively] at the time of unconciousness (P 0.01),but BIS values between two groups had no statistical differences (P 0.05).Conclusions The hemodynamics are stable and intubation stress reaction is mild when TCI of suffentanil (Ce 0.6μg/L) combined with propofol for patients with liver dysfunction during induction of anesthesia.There are no singnificant side effects,such as respiratory depression and muscular stiffness,which indicates this method is feasible and safe.The BIS value can not be changed by TCI of Sufentanil at Ce 0.6μg/L and 0.8μg/L but the Ce value of propofol can be reduced with the use of propofol combined with the sufentanil.