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Sufentanil supplementation of sevoflurane during induction of anaesthesia: a randomized study

Published online by Cambridge University Press:  28 January 2005

E. Meaudre
Affiliation:
Military Teaching Hospital, Department of Anaesthesia, Toulon-Naval, France
H. Boret
Affiliation:
Military Teaching Hospital, Department of Anaesthesia, Toulon-Naval, France
A. Suppini
Affiliation:
Military Teaching Hospital, Department of Anaesthesia, Toulon-Naval, France
M. Sallaberry
Affiliation:
Military Teaching Hospital, Department of Anaesthesia, Toulon-Naval, France
S. Benefice
Affiliation:
Military Teaching Hospital, Department of Anaesthesia, Toulon-Naval, France
B. Palmier
Affiliation:
Military Teaching Hospital, Department of Anaesthesia, Toulon-Naval, France
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Extract

Summary

Background and objective: The use of opioids with sevoflurane for induction of anaesthesia is associated with fewer reactions to laryngoscopy but increases the risk of apnoea. Thus it is important to search for the optimal opioid dose. The aim of this study was to compare two sufentanil doses during induction with sevoflurane in young adults.

Methods: Sixty-three young patients (18–26 yr) undergoing wisdom-tooth extraction were randomly allocated to one of the two sufentanil dose groups: 0.15 μg kg−1 (n = 33) or 0.30 μg kg−1 (n = 30). Sufentanil was injected 1 min before sevoflurane inhalation. Sevoflurane was inhaled using the three-breath vital-capacity technique with 8% sevoflurane and 100% oxygen. The anaesthesiologist decided when to intubate the trachea. The length of time for intubation was measured. In addition, any apnoea, patient movement, adequacy of the laryngoscopic view, coughing and haemodynamic responses were recorded.

Results: Mean time to intubate the trachea, full laryngoscopy view and open-cord position were similar in both groups. The incidence of apnoea was higher in Group 0.30 (P < 0.05). The incidence of patient movement (P < 0.05) and coughing (P < 0.001) was lower in Group 0.30 than in Group 0.15. Sufentanil 0.30 μg kg−1 attenuated the change in heart rate more effectively than sufentanil 0.15 μg kg−1. Mean arterial pressure was similar and stable in both groups during induction of anaesthesia.

Conclusions: In current clinical practice during sevoflurane induction, sufentanil 0.30 μg kg−1 provided a better quality of induction than sufentanil 0.15 μg kg−1, without significant cardiovascular depression, although the risk of apnoea is increased.

Type
Original Article
Copyright
© 2004 European Society of Anaesthesiology

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References

Muzi M, Robinson BJ, Ebert TJ, O'Brien TJ. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996; 85: 536543.Google Scholar
Kimura T, Watanabe S, Asakura N, et al. Determination of end-tidal sevoflurane concentration for tracheal intubation and minimum alveolar anesthetic concentration in adults. Anesth Analg 1994; 79: 378381.Google Scholar
Plastow SE, Hall JE, Pugh SC. Fentanyl supplementation of sevoflurane induction of anaesthesia. Anaesthesia 2000; 55: 475478.Google Scholar
Katoh T, Ikeda K. The effects of fentanyl on sevoflurane requirements for loss of consciousness and skin incision. Anesthesiology 1998; 88: 1824.Google Scholar
Sivalingam P, Kandasamy R, Dhakshinamoorthi P, Madhavan G. Tracheal intubation without muscle relaxant – a technique using sevoflurane vital capacity induction and alfentanil. Anaesth Intens Care 2001; 29: 383387.Google Scholar
Cros AM, Lopez C, Kandel T, Sztark F. Determination of sevoflurane alveolar concentration for tracheal intubation with remifentanil, and no muscle relaxant. Anaesthesia 2000; 55: 965969.Google Scholar
Joo HS, Perks WJ, Belo SE. Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents. Can J Anaesth 2001; 48: 646650.Google Scholar
Hall JE, Stewart JI, Harmer M. Single-breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: a feasibility study in adults and comparison with an intravenous bolus of propofol. Anaesthesia 1997; 52: 410415.Google Scholar
Kay B, Nolan D, Mayall R, Healy TE. The effect of sufentanil on the cardiovascular responses to tracheal intubation. Anaesthesia 1987; 42: 382386.Google Scholar
Shafer SL, Varvel JR. Pharmacokinetics, pharmacodynamics, and rational opioid selection. Anesthesiology 1991; 74: 5363.Google Scholar
Yurino M, Kimura H. A comparison of vital capacity breath and tidal breathing techniques for induction of anaesthesia with high sevoflurane concentrations in nitrous oxide and oxygen. Anaesthesia 1995; 50: 308311.Google Scholar
Katoh T, Nakajima Y, Moriwaki G, et al. Sevoflurane requirements for tracheal intubation with and without fentanyl. Br J Anaesth 1999; 82: 561565.Google Scholar
Brunner MD, Braithwaite P, Jhaveri R, et al. MAC reduction of isoflurane by sufentanil. Br J Anaesth 1994; 72: 4246.Google Scholar
Philbin DM, Rosow CE, Schneider RC, Koski G, D'Ambra MN. Fentanyl and sufentanil anesthesia revisited: how much is enough? Anesthesiology 1990; 73: 511.Google Scholar