Comparison between Sufentanil and Remifentanil Given by Target-Controlled Infusion in Neurosurgery Patients

Objective: To compare the effects of sufentanil or remifentanil given by target-controlled infusion in neuro-surgery patient. Methods: Forty ASAⅠ-Ⅱpatients undergoing elective neurosurgery were studied. The patients were divided into 2 groups which included sufentanil (SF) (groupⅠ, n=20) and remifentanil (RF) (groupⅡ, n=20). The target effect-site concentration of sufentanil was 0.5 μg/L and remifentanil was 4.0 μg/L. TCI of propofol was started at target plasma concen-tration of 3.0 mg/L in increment of 0.5 mg/L per 30s. When consciousness lost, rocuronium 0.6 mg/kg was given and tracheal in-tubation was practiced. Target concentrations of sufentanil, remifentanil and propofol were adjusted, and maintained BIS value between 40 and 60. MAP and HR were recorded at preoxygenation (T0), tracheal intubation (T1), skin incision (T2), dura apply (T3) and skin seam(T4). Anaesthesia time, dosage of sufentanil, remifentanil and propofol during anaesthesia, the supplemen-tary drugs, extubate time and VAS score after extubate were recorded. Results: The minimum and maximum of target effect-site concentration of sufentanil were (0.30±0.02)and(0.61±0.03)μg/L in group SF respectively, and the two value were(1.02±0.18) and (5.01±0.34) μg/L respectively in group RF. There was no difference in dosage of propofol between two groups. In group RF, MAP and HR were decreased at T1 and T2 than that at T0(P 0.05). MAP and HR were decreased at T1 and T2 in group RF than that in group SF(P 0.05). The extubate time was shorter in group RF than that in group SF, but the VAS score was higher in group RF than that in group SF(P 0.05). Conclusion: Anaesthesia with TCI of sufentanil or remifentanil can provide satisfactory effect of anaesthesia for neurosurgery. Sufentanil can provide steady hemodynamics and powerful analgesic effect, but late recovery. However, remifentanil had rapid recovery. Attention should be paid to the changes in MAP and HR.