[A sufentanil dosage study in general surgery]

Sufentanil is widely used for cardiac surgery in initial doses up to 15 micrograms/kg. It was expected that for general surgery much smaller doses would be appropriate. The aim of the study, therefore, was to find a dosage scheme for sufentanil that could be used in general surgery for operations lasting 1 h. METHODS. In 62 patients (Table 1), anesthesia was induced with 15 micrograms sufentanil and 0.2 mg/kg etomidate. According to a random group allocation, a bolus injection of sufentanil was administered 1 min before incision, so that the patients received 0.5, 1.0 or 1.5 micrograms/kg along with the initial dose. During maintenance anesthesia, repeat doses of 10 micrograms sufentanil were injected as required (rise in blood pressure and/or heart rate by more than 20%, or other stress signs i.e., sweating, movement). Intubation was facilitated by means of atracurium 0.5 mg/kg. Increments of 5-10 mg were given when needed. RESULTS. In the group of patients who had received 1.0 micrograms/kg, both the number requiring repeat doses, and the total number of repeat doses were significantly lower than in the 0.5 microgram/kg group. A further increase to 1.5 micrograms/kg did not prove to have any advantage and it led to a drop in blood pressure, that was more pronounced and of longer duration than in the other groups. CONCLUSION. A dose of 1.0 micrograms/kg, therefore, appeared to be the optimum initial dose in general surgery for operations lasting at least 1 h.