ABSTRACT

To investigate the effects of fentanyl and sufentanil on hemodyna-mic and endocrine responses in patients undergoing abdominal hysterectomy under general anesthesia

Forty ASA I-II patients scheduled for abdominal hysterectomy were randomly allocated to receive either 5 mg kg-1 thiopental, 1.5 mg kg-1 fentanyl, and 0.1 mg kg-1 vecuronium or 0.3 mg kg-1 sufentanil and the same amounts of thiopental and vecuronium. The anesthesia was maintained with sevoflurane and a 50% O2+N2O mixture. The bispectral index (BIS) monitoring was per-formed and fentanyl (50 mg) or sufentanil (5 mg) supplements were added to keep BIS at the 50±5 level. Mean arterial pressure (MAP) and heart rate (HR) were recorded. Plasma concentrations of glucose, insulin, prolactin, and corti-sol were measured three times in the blood.

MAP and HR were significantly decreased from the 10th min of intu-bation in both groups (p<0.05). Although it was not significant, MAP and HR were lower in the sufentanil group than in the fentanyl group (p>0.05). While plasma glucose and prolactin concentrations were increasing from baseline va-lues 30 min after skin incision, plasma glucose, prolactin and cortisol levels were increased after extubation in both groups (p<0.001). However, increments in the concentrations of glucose, prolactin, and cortisol were significantly lower in the sufentanil group than in the fentanyl group (p<0.05).

Sufentanil was similar to fentanyl in attenuating the hemodyna-mic responses to tracheal intubation and surgery in abdominal hysterectomy. However, sufentanil provided better stress endocrine responses than fentanyl to surgical stimulation