A comparison of remifentanil and sulfentanyl for fast-track paediatric cardiac anaesthesia

LI Biwan; TAN Wenhao; CHEN Xian; LU Bintan; MO Weibo; NING Haichang; ZHANG Yushu

Abstract：Objective:To evaluate the effects of remifentanil and sulfentanyl on hemodynamics,stress-reaetion and out-comes in pediatric undergoing fast-track cardiac anesthesia. Methods:All 120 patients with Atrial septal defect( ASD)and (or)Ventricular septal defect(VSD)were randomly assigned to group R with bolus infusion of 0. 16 μg·kg-1 ·min-1 emifentanil and group S with bolus infusion of 1 μg·kg-1 ·h-1 sulfentanyl. The perioperative heart rate and arterial pressure were recorded. Serum adrenocorticotrophic hormone( ACTH),cortisol( COR),glucose( BG)and lactate acid( LAC)levels were measured accordingly. Cases of postoperative agitation,cardiovascular active drugs uses after re-beat,sedatives and analgesic uses 24 hours after operation and postoperative recovery condition were observed. Results:No difference was found on the heart rate andarterial pressure intraoperative changes between two groups. During extubation the heart rate and arterial pressure rise higher in group R,and come down slower also(P﹤0. 01). Serum adrenocorticotrophic hormone(ACTH),cortisol(COR),glu-cose( BG)and lactate acid( LAC)increased gradually after induction in both groups and peaked at theend of operation,then fell back but slower in group R(P﹤0. 01). Extubation time was shorter in group R(P﹤0. 01). Although postoperative agita-tion rate was higher(P﹤0. 05),cases of postoperative sodium nitroprusside use and sedatives and analgesic uses 24 hours after operation were more in group R(P﹤0. 05),there was no difference on postoperative ICU stay and hospital stay between two groups,and the same as cases of postoperative reintubation and respiratory complication. Conclusion:There were equivalent perioperative hemodynamic stability and stress reaction control in pediatric undergoing fast-track cardiac anesthesia with small doses infusion of remifentanil and sulfentanyl,the postoperative prognosis was good,and extubation wasearlier in group R.