Effects of different doses of sufentanil combined with target controlled infusion of propofol on hemodynamics in patients during anesthesia induction: a prospective, multicenter, randomized, double-blind study

Objective To investigate the effects of different doses of sufentanil combined with target controlled infusion （TCI） of propofol on hemodynamics in patients during anesthesia induction and the appropriate dose of sufentanil. Methods This was a prospective, muhicenter, randomized, double-blind clinical trial. One hundred and sixty-five patients of both sexes, ASA Ⅰ or Ⅱ , aged 18-63 yr, weighing 42-90 kg, scheduled for elective abdominal surgery, were divided into 4 groups according to the different induction doses of sufentanil： snfcntanil 0.4μg/kg group （group S1 , n =44）, 0.6 μg/kg group （group S2 , n =43）, 0.8 μg/kg group （group S3 , n = 38） and 1 μg/kg group （group S4 , n = 40）. Anesthesia was induced with iv injection of midazolam 0.05 mg/kg, TCI of propofol （target plasma concentration set at 3.0 μg/ml） and iv injection of sufentanil 0.4, 0.6, 0.8 and 1 μg/kg. Tracheal intubation was facilitated with rocuronium 0.9 mg/kg. The patients were mechanically ventilated （BIS at 35-45）. Systolic pressure （SP）, diastolic pressure （DP）, MAP and HR were recorded before induction of anaesthesia （T0）, at the time of propofol achieving the target plasma concentration of 3.0 μg/ml （T,）, at 1 min （T2） and 3 min（T3） after injection of sufentanil, and immediately （T4） and at 1 min （T5）, 3 min （T6 ） and 5 min （T7） after tracheal intubation. The adverse cardiovascular events including bradycardia, tachycardia, hypertension and hypotension, and hemodynamic responses to intubation were also recorded. Results There were no significant differences in the incidence of hypotension, hypertension and tachycardia during anesthesia induction between 4 groups. The incidence of bradycardia at T4-7 was significantly higher in group S4 than in the other 3 groups. The incidence of intubation response was significantly higher in group S1 and S2 than in group S3 and S4. Conclusion Sufentanil 0.8 μg/kg is the dose of choice for anesthesia induction when combined with propofol TCI （target plasma concentration set at 3.0 μg/ml） in patients and hemodynamics is stable. Key words: Sufentanil ;  Propofol;  Drug delivery systems ;  Hemodynamic phenomena