Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology and Intensive Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
Institute of Global Health, Medical Faculty, University of Geneva, Geneva, Switzerland.
Anaesthesia. 2018 Feb;73(2):216-222. doi: 10.1111/anae.14102. Epub 2017 Nov 3.
We examined the impact of adding sufentanil during anaesthesia induction with propofol on bispectral index values in elderly patients (≥ 65 years). Patients were randomly assigned to receive a target-controlled sufentanil infusion (effect-site concentration of 0.3 ng.ml ) or matching placebo, followed by a target-controlled propofol induction (initial effect-site concentration of 0.5 μg.ml ; step-wise increase of 0.5 μg.ml ) until loss of consciousness defined as an Observer's Assessment of Alertness/Sedation score < 2. Seventy-one patients (sufentanil 35, placebo 36) completed the study. Mean (SD) age was 72.3 (5.8) years; 41% were women. At loss of consciousness, mean (SD) bispectral index value was 75.0 (8.6) with sufentanil and 70.0 (8.0) with placebo; mean difference -5.0 (95% confidence interval -8.9 to -1.1), p = 0.013. Post-hoc analyses suggest that the difference was significant in men only (mean difference -7.3 (-11.8 to -2.6), p = 0.003). Sufentanil co-induction with propofol results in higher bispectral index values at loss of consciousness in elderly patients.
我们研究了在老年患者（≥65 岁）中，在异丙酚麻醉诱导时加入舒芬太尼对脑电双频指数值的影响。患者被随机分配接受靶控舒芬太尼输注（效应部位浓度为 0.3ng/ml）或匹配的安慰剂，然后接受靶控异丙酚诱导（初始效应部位浓度为 0.5μg/ml；逐步增加 0.5μg/ml），直到意识丧失定义为观察者警觉/镇静评分<2。71 名患者（舒芬太尼 35 名，安慰剂 36 名）完成了这项研究。平均（SD）年龄为 72.3（5.8）岁；41%为女性。在意识丧失时，舒芬太尼的脑电双频指数值为 75.0（8.6），安慰剂为 70.0（8.0）；平均差值-5.0（95%置信区间-8.9 至-1.1），p=0.013。事后分析表明，这种差异仅在男性中具有统计学意义（平均差值-7.3（-11.8 至-2.6），p=0.003）。舒芬太尼与异丙酚联合诱导可使老年患者意识丧失时的脑电双频指数值更高。
