Indian Journal of Anaesthesia (Jan 2009)
Comparison of Total Intravenous Anaesthesia Using Propofol with or without Sufentanil in Laparoscopic Cholecystectomies
Abstract
Sufentanil is an excellent adjuvant in total intravenous anaesthesia (TIVA). The present study evaluates effec-tiveness of differentconeentrations of Sufentanil mixed in propofol for TI VAin laparoscopic cholecystectomy. Sixty adult patients of ASA physical status I or II (randomly divided into 3 groups of twenty each) undergoing elective laparoscopic cholecystectomy were included in this randomised control study. At induction, patients in all groups received i.v. bolus of Sufentanil 1ìg kg-1 and continuous infusion of 100 ìg kg-1 min -1 . Anaesthesia was maintained with propofol infusion titrated in a range of 75 to 125ìg kg-1 min -1 . Groups S 1 and S2 received propofol with Sufentanil added at 1ìg ml -1 and 2 ìg ml -1 concentrations respectively, while group Preceived propofol without Sufentanil. Additional Sufentanil boluses (10 ìpg) were given to patients in all groups when there was an increase in the heart rate by more than 20 beats per minute or mean arterial pressure by more than 15% above baseline. Perioperative haemodynamic parameters, recovery times and postoperative analgesia were compared across the three groups of patients. Haemodynamie parameters (heart rate, systolic and diastolic blood pressures) were not significantly differ-ent across the three groups of patients in the perioperative period. Fewer Group S2 patients required additional Sufentanil boluses to maintain adequate depth of anaesthesia compared to other two groups. Group S2 patients had better post-operative analgesia (p=0.01) but prolonged recovery time (p=0A01) compared to the other two groups. Sufentanil mixed with propofol provides better haemodynamic stability in laparoscopic eholecystectomies, with lesser requirementfor additional Sufentanil boluses, and good postoperative analgesia.
