Comparison of total intravenous anaesthesia using propofol with or without sufentanil in laparoscopic...

Sufentanil is an excellent adjuvant in total intravenous anaesthesia (TIVA). The present study evaluates effectiveness of different concentrations of Sufentanil mixed in propofol for TIVA in 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 1 mug kg(-1) and continuous infusion of 100 mug kg(-1) min(-1). Anaesthesia was maintained with propofol infusion titrated in a range of 75 to 125 mug kg(-1) min(-1). Groups S1 and S2 received propofol with Sufentanil added at 1 mug ml(-1) and 2 mug ml(-1) concentrations respectively, while group Preceived propofol without Sufentanil. Additional Sufentanil boluses (10 mug) 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. Haemodynamic parameters (heart rate, systolic and diastolic blood pressures) were not significantly different 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=0.001) compared to the other two groups. Sufentanil mixed with propofol provides better haemodynamic stability in laparoscopic cholecystectomies, with lesser requirement for additional Sufentanil boluses, and good postoperative analgesia.