Efficacy and safety of sufentanil combined with sevoflurane on inhibiting the skin incision reaction

Objective To investigate the changes of hemodynamics and BIS in blunting surgical incision targeted controlled by sufentanil combined with sevoflurane, at different concentrations, and to explore the optimum combined doses. Method 80 patients undergoing abdominal operation, ASAⅠ～Ⅱ, 20～60 year old,, were randomly divided into 4 groups (n=20 cases): S0,S1,S2,S3. In skin incision, the concentrations of sevoflurane were 2.3%,1.6%,1.1%,0.9% in S0,S1,S2,S3 group respectively ,and the concentrations of sufentanil were 0,0.12 ng/mL, 0.18 ng/mL, 0.24 ng/mL respectively. Anesthesia was induced with propofol(Cp 3.5 μg/mL), remifentanil(Ce 4 ng/mL)and rocuronium (0.6 mg/kg)for all patients. After intubation, the propofol and remifentanil were immediately stopped and the lungs were ventilated with sevoflurane and a mixture of 60% nitrous oxide and 40% oxygen,The concentrations of sufentanil and sevoflurane were adjusted to targeted concentrations.The changes of MAP、HR and BIS were compared before and after incison among groups and within every group.Results MAP was not significant different among groups(P0.05);HR in S1、S2 and S3 group were lower than in S0 group(P0.05),and BIS increased in S2 and S3 group(P0.05). Before and after incison within every group, MAP increased in S0、S1、S2 and S3 group (P0.05);HR increased in S0 group (P0.05); BIS increased in S3 group (P0.05). Conclusion Targeted concentration 0.12 ng/mL sufentanil combined with 1.6% sevoflurane and targeted concentration 0.18 ng/mL sufentanil combined with 1.1% sevoflurane can effectively and safely blunt the adrenergic response to abdominal incision, which was the suitable combined concentration during abdominal incision period.