Comparison of different kinds of opioids with propofol through continuous intravenous infusion in intracranial surgery

Objective To compare the application of propofol combining with fentanyl,sufentanil,and remifentanil in intracranial surgery.Method 75 patients were randomly divided into three groups: fentanyl group,sufentanil group,remifentanil group.Blood flow indicators during operation,waking and complications were monitored.VAS and OAAS grades were evaluated.Results Mean artery pressure(MAP),heart rate(HR) in fentanyl group during opening or closing skull or extubation were significantly higher than basic evaluations(P0.05),but sufentanil group and remifentanil group were lower than basic evaluations during opening or closing skull and intracranial period(P0.05);MAP and HR of fentanyl group in every intracranial episodes were higher than sufenanil group and remifentanil group(P0.05),but remifentanil group was significantly lower than sufentanil group during opening skull or intracranial period(P0.05);pinprick reaction emergence time of sufentanil group was longest(11.7±1.6,P0.05),remifentanil group was shortest(6.0±1.2,P0.05);5 minutes after extubation,OAAS grades of fentanyl group were lowest(2.0±0.3).There was no variance between sufentanil group and remifentanil group(P0.05);VAS grades of sufentanil group at 1 h,2 h,4 h points after operations was significantly lower than fentanyl group and remifentanil group(P0.05).12 h point was the peak,no statistic variance after 8 h;PONV rate of fentanyl group was significantly higher than sufentanil group and remifentanil group(P0.05).Conclusions Remifentanil combining with propofol through continuous intravenous infusion is superior to fentanyl or sufentanil in intracranial surgery.Sufentanil is superior to fentanyl.