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. 2016 Apr 4;6(2):e33640.
doi: 10.5812/aapm.33640. eCollection 2016 Apr.

Effective Bolus Dose of Sufentanil to Attenuate Cardiovascular Responses in Laryngoscopic Double-Lumen Endobronchial Intubation

Byung-Hee Choi  1 , Yong-Cheol Lee  1
Affiliations

Effective Bolus Dose of Sufentanil to Attenuate Cardiovascular Responses in Laryngoscopic Double-Lumen Endobronchial Intubation

Byung-Hee Choi et al. Anesth Pain Med. .

Abstract

Background: Sufentanil is a potent opioid analgesic frequently used in clinical anesthesia. Double-lumen endobronchial intubation induces profound cardiovascular responses in comparison with ordinary endotracheal intubation because of the larger tube diameter and direct irritation of the carina.

Objectives: The purpose of this study was to determine the effective bolus dose of sufentanil to attenuate hemodynamic changes in response to laryngoscopic double-lumen endobronchial intubation.

Patients and methods: We randomly assigned 72 patients aged 18 - 65 years and with an American Society of Anesthesiologists physical status of 1 or 2 to one of four sufentanil dose groups: NS, S0.1, S0.2, or S0.3. The respective doses for the groups were as follows: normal saline, 0.1 mcg/kg of sufentanil, 0.2 mcg/kg of sufentanil, and 0.3 mcg/kg of sufentanil. Blood pressure and heart rate were recorded during the pre-anesthesia period at baseline, pre-intubation, immediate post-intubation, and every minute during 5 minutes after intubation.

Results: Baseline mean arterial pressures in the NS, S0.1, S0.2, and S0.3 groups were 89.8 ± 12.1, 89.2 ± 10.9, 88.8 ± 13.6, and 90.7 ± 11.1, respectively. At immediate post-intubation, the mean arterial pressures in the NS, S0.1, S0.2, and S0.3 groups were 129.7 ± 14.7, 120.7 ± 14.2, 120.8 ± 17.2, and 96.7 ± 10.4, respectively. At immediate post-intubation, the mean arterial pressure in the NS, S0.1, and S0.2 groups significantly increased from baseline (P < 0.001), but the S0.3 group showed no difference. In the time point comparison at immediate post- intubation, the S0.3 group had a significantly lower mean arterial pressure than did the NS, S0.1, and S0.2 groups (P < 0.001).

Conclusions: We found that 0.3 mcg/kg of sufentanil attenuates cardiovascular responses to double-lumen endobronchial intubation without adverse effects.

Keywords: Cardiovascular; Hemodynamic; Intubation; Laryngoscopy; One-Lung Ventilation; Sufentanil.

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Figures

Figure 1.
Figure 1.. Changes in Systolic Blood Pressure
Values are presented as means ± SD. NS: group receiving normal saline; Pre-I: preintubation; Post-I: post intubation; S0.1: group receiving 0.1 μg/kg of sufentanil; S0.2: group receiving 0.2 μg/kg of sufentanil; S0.3: group receiving 0.3 μg/kg of sufentanil. *: P < 0.05 compared with baseline; **: P < 0.05 compared with NS; ***: P < 0.05 compared with S0.1; ****: P < 0.05 compared with S0.2.
Figure 2.
Figure 2.. Changes in Diastolic Blood Pressure
Values are presented as means ± SD. NS: group receiving normal saline; Pre-I: preintubation; Post-I: post intubation; S0.1: group receiving 0.1 μg/kg of sufentanil; S0.2: group receiving 0.2 μg/kg of sufentanil; S0.3: group receiving 0.3 μg/kg of sufentanil. *: P < 0.05 compared with baseline; **: P < 0.05 compared with NS; ***: P < 0.05 compared with S0.1; ****: P < 0.05 compared with S0.2.
Figure 3.
Figure 3.. Changes in Mean Arterial Pressure
Values are presented as means ± SD. NS: group receiving normal saline; Pre-I: preintubation; Post-I: post intubation; S0.1: group receiving 0.1 μg/kg of sufentanil; S0.2: group receiving 0.2 μg/kg of sufentanil; S0.3: group receiving 0.3 μg/kg of sufentanil. *: P < 0.05 compared with baseline; **: P < 0.05 compared with NS; ***: P < 0.05 compared with S0.1; ****: P < 0.05 compared with S0.2.
Figure 4.
Figure 4.. Changes in Heart Rate
Values are presented as mean ± SD. NS: group receiving normal saline; Pre-I: preintubation; Post-I: post intubation; S0.1: group received 0.1 μg/kg of sufentanil; S0.2: group received 0.2 μg/kg of sufentanil; S0.3: group received 0.3 μg/kg of sufentanil; *: P < 0.05 compared with baseline; **: P < 0.05 compared with NS; ***: P < 0.05 compared with S0.1; ****: P < 0.05 compared with S0.2.
Figure 5.
Figure 5.. Changes in Bispectral Index Scale Values
Values are presented as mean ± SD. NS: group receiving normal saline; Pre-I: preintubation; Post-I: post intubation; S0.1: group receiving 0.1 μg/kg of sufentanil; S0.2: group receiving 0.2 μg/kg of sufentanil; S0.3: group receiving 0.3 μg/kg of sufentanil. *: P < 0.05 compared with baseline.
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