Low-dose sufentanil and lidocaine supplementation of general anaesthesia

Abstract

This randomized double-blind study compared the effects of: (1) saline infusion (C); (2) sufentanil alone (1.0 μg · kg-1) (S); and (3) low-dose sufentanil (0.5μg · kg-1) in combination with lidocaine (1.5 mg · kg-1) (LS); on the cardiovascular responses to tracheal intubation and on postoperative ventilation as monitored by respiratory inductive plethysmography in day-care surgical procedures of approximately 60 min duration. Thirty healthy, unpremedicated patients were studied. Thiopentone requirements were reduced by 40 and 28 per cent in the S and LS groups respectively compared with control (P < 0.001). Both treatments suppressed HR and BP responses (P < 0.005) to intubation. Postoperatively, PaCO2 was elevated (P < 0.05) in group S. Dose-related respiratory depression was observed. The incidence of postoperative apnoea was significantly higher in both S and LS groups than compared with control (P <0.05). However, only patients in group S showed higher apnoea index and mean apnoea duration over the initial 10-20 min after surgery compared with control (P < 0.005). In addition, group S showed slower respiratory frequency and prolonged expiratory time (P < 0.005). In conclusion, an induction dose of sufentanil (I μg · kg-1) used in balanced anaesthesia of less than 70 min duration was associated with significant respiratory depression, particularly during the initial 10-20 min after surgery, whereas low-dose sufentanil (0.5 μg· kg-1) with lidocaine (1.5 mg · kg-1) had minimal postoperative respiratory depression and comparable attenuation ofpressor responses to intubation. © 1990 Canadian Anesthesiologists.