Sufentanil in preventing acute postoperative pain after remifentanil based anesthesia in elderly patients undergoing abdominal surgery:a comparison between target controlled infusion and bolus injection

Objective To compare the efficiencies of sufentanil when administered via target controlled infusion(TCI)and Bolus injection in preventing acute postoperative pain after remifentanil based anesthesia in elderly patients undergoing abdominal surgery.Methods Totally 70 elderly patients were randomly assigned to group T(TCI,n=35)and group S(Bolus injection,n=35).Standardized propofol/remifentanil based general anesthesia was performed.Thirty minutes before the end of surgery,patients in group T received sufentanil TCI with the effect compartment concentration being 0.2 μg/L until the surgeries were finished,while patients in group S received a sufentanil 0.4 μg/kg bolus injection.Heart rate(HR)and mean artery pressure(MAP)were recorded before and after sufentanil were given.The recovery time,including opening eyes,extubating and asking for analgesic were also recorded.Ramsay sedative scale(RSS),visual analogue scale(VAS)and complications were evaluated.Results In group S,HR and MAP descended after sufentanil was given(P0.01)and the hemodynamics was stable in group T.The accumulation of sufentanil in group T was less than that in group S(P0.01).Time of opening eyes,extubuting and asking for analgesic were comparable in two groups(P0.05).RSS in group T was lower in the early stage after surgical procedure compared with that in group S(P0.05).VAS and complications such as respiratory depression,nausea and vomiting,or pruritus had no statistical difference between the two groups.Conclusion For elderly patients undergoing abdominal surgery,sufentanil TCI at 0.2 μg/L can obtain the same effect as bolus injection at 0.4 μg/kg in preventing acute postoperative pain after remifentanil based anesthesia,and sufentanil TCI has less influence on hemodynamics and better recovery.