The application of sufentanil by effect compartment-controlled target-controlled infusion during laparoscopic cholecystectomy

Objective To study the application of sufentanil by effect compartment-controlled target-controlled infusion(TCI) during laparoscopic cholecystectomy,investigate the appropriate TCI concentration.Methods 75 patients undergoing laparoscopic cholecystectomy were randomly divided into 5 groups (n=15):sufentanil effect compartment concentration 0.2 μg/L (group A),0.3 μg/L (group B),0.4 μg/L (group C) and 0.5 μg/L (group D),fentanyl 3 μg/kg i.v.(group E).The concentration of propofol and the use of vasoactive drug were directed by MAP,HR and Narcotrend index(NI).MAP and HR were recorded at the time points of before anesthesia induction (T0),immediately before and after LMA-SupremeTM insertion (T1-2),5min after LMA-SupremeTMinsertion (T3),beginning of surgery (T4),establishment of pneumoperitoneum (T5),beginning of freeing the gallbladder (T6),end of freeing cystic artery (T7),cutting the gallbladder (T8),end of surgery (T9),eyes opening (T10),pulling out the laryngeal mask (T11),leaving off the operating room (T12).The use of vasoactive drug,times of adjusting propofol,awakening time,side effects were recorded.Results MAP and HR were significantly decreased at T1-3 compared with the baseline at T0 in all groups (P＜0.05).The MAP at T1-3 in group A were(75±6),(79±7),(75±6) mm Hg(1 mm Hg=0.133 kPa) respectively,and changed lighter than that in other groups.Compared with MAP at TO,there was significantly increased at T6 in all groups.The MAP at T6 in group A and B were (117±11 ) and (114±13) mm Hg respectively,and higher than that in group C (P＜0.05).Both MAP and HR in group B,C and D were significantly decreased at T11 compared with that in group E (P＜0.05).In group C,the times of altering propofol with (2.5±0.6) was less than that in other groups.The awakening time in group D with (13.3±3.4) min was longer than that in group E (P＜0.05).Conclusions Sufentanil by effect compartment-controlled TCI is used well in laparoscopic cholecystectomy,the most appropriate induction and maintenance concentrations were 0.2 μg/L and 0.4 μg/L respectively. Key words: Sufentanil;  Target-controlled infusion;  Laparoscopic cholecystectomy