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

ABSTRACT

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 microg kg(-1) (n = 33) or 0.30 microg 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 microg kg(-1) attenuated the change in heart rate more effectively than sufentanil 0.15 microg 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 microg kg(-1) provided a better quality of induction than sufentanil 0.15 microg kg(-1), without significant cardiovascular depression, although the risk of apnoea is increased.