Effects of sufentanil,remifentanil or fentanyl on stress responses of patients during induction of general anesthesia

Objective: To compare the effects of sufentanil,remifentanil or fentanyl on hemodynamic and stress responses of patients during induction of general anesthesia.Methods: In a randomized,double-blind study, sixty ASA Ⅰ～Ⅱ patients undergoing elective abdominal surgery under general anesthesia were divided into sufentanil group(S,n=20),remifentanil group(R,n=20) and fentanyl group(F,n=20).SBP,DBP,MAP,HR and SpO_2 were recorded before induction of anesthesia(T,baseline),immediately after tracheal intubation(T_0),1,3 and 5minutes after intubation(T_1,T_2,T_3).At the same time,plasma norepinephrine(NE) and epinephrine(E) were determined by high performance liquid chromatography.Results: The MAP and HR in three groups at T_0 were significantly lower than those at T,and decreased much greatly in group R than in group F and S.The MAP and HR in group F significantly increased at T_1 than T,and returned to baseline at T_2 and T_3.The MAP and HR in group R at T_1 were not significantly different from those at T,but gradually decreased;the levels at T_2,T_3 were significantly lower than at baseline and in group F or S.Compared with the baseline,the MAP and HR in group S at T_1,T_2,T_3 remained unchanged. In group R,there were two patients whose HR were under 55·min~(-1).In group F,the plasma NE and E at T_1,T_2 were significantly higher than those at T. In group R and S,there were no significant changes in plasma NE and E,which were all within normal range.Conclusion: Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.