Evaluation of sufentanil as a supplement to anaesthesia in lengthy spinal surgery

The efficacy of sufentanil citrate as a supplement to anaesthesia was studied in 31 patients undergoing lengthy spinal surgery (mean duration 150 min). Anaesthesia was induced with 1 microgram/kg sufentanil (bolus) and 2 mg/kg thiopental, followed by 1.5 mg/kg succinylcholine to facilitate intubation, all given intravenously; after intubation, administration of N2O:O2 (70:30) was started. Further doses of sufentanil (10-25 micrograms) were given, on average 2.3 times, depending on the length of the operation, systolic blood pressure, pulse rate and other autonomous signs; the mean total amount of sufentanil administered was 126.3 micrograms. Our findings showed that sufentanil provided good cardiovascular stability and rapid recovery. More specifically mean arterial blood pressure and heart rate were significantly reduced 1 min after intubation (P < or = 0.001). Thereafter mean arterial blood pressure increased, returning to preanaesthesia values and remaining constant while heart rate remained constant throughout the operation at values similar to the value immediately after induction of anaesthesia. Recovery was rapid, awakening time was 6 min or less in 50% of patients and 10 min or less in 90% of patients, while the corresponding values for response time were 8 and 12 min, for extubation time, 9 and 13 min, and for orientation time, 15 and 19 min. Two patients experienced nausea and vomiting and one patient mild chest-wall rigidity. Finally, respiratory depression was not observed in any of the patients.