Comparison of bradycardia induced by equivalent doses of fentanyl,sufentanil,and remifentanil in elderly patients during induction of general anesthesia

OBJECTIVE To compare the incidence and severity of bradycardia induced by equivalent doses of fentanyl,sufentanil,and remifentanil in the elderly patients during induction of general anesthesia.METHODS Ninety elderly patients(ASA Ⅰ-Ⅱ)undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R)and fentanyl group(group F)(n=30 each group).Patients in group S,group R and group F received sufentanil 0.2μg·kg-1,remifentanil 2μg·kg-1 and fentanyl 2μg·kg-1 Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR were recorded before of anesthesia(T0),immediately after induction(T1),1,3 minutes after tracheal intubation(T2,T3).Changes of SBP and HR during observation were also recorded.RESULTS The SBP and HR in group R at T1 were significantly lower than those in group S and group F(P0.05).The SBP and HR in group F increased much greater than those in group S and group R after tracheal intubation(T2,T3,)(P0.05).The hemodynamics in group S remained unchanged at the same time.The rate of serious bradycardia in group R was 40%(12/30),however,7%(2/30)in group F and 10%(3/30)in group S(P0.05).there were three patients whose HR became critical bradycardia(under 45 bpm)needing adjustment in group R.CONCLUSION Remifentanil induces a higher incidence and more severity of bradycardia than equivalent doses of sufentanil and fentanyl,at the same time,sufentanil has better hemodynamic effects than fentanyl,it is benefit for elderly patients in induction of general anesthesia.