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Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices

World Journal of Gastroenterology 2017年第44期23卷 7875-7880页

作者： Yang Yu Sheng-Lin Qi Yong Zhang Department of Anesthesiology the Sixth People’s Hospital of Dalian Endoscopy Center the Sixth People’s Hospital of Dalian President Office the Sixth People’s Hospital of Dalian

AIM To investigate the efficacy and safety of a combination of sufentanil and propofol injection in patients undergoing endoscopic injection sclerotherapy(EIS) for esophageal varices(EVs). METHODS Patients with severe EVs who underwent EIS with sufentanil and propofol anesthesia between April 2016 and July 2016 at our hospital were reviewed. Although EIS and sequential therapy were performed under endotracheal intubation, we only evaluated the efficacy and safety of anesthesia for the first EIS procedure. Patients were intravenously treated with 0.5-1 μg/kg sufentanil. Anesthesia was induced with 1-2 mg/kg propofol and maintained using 2-5 mg/kg per hour of propofol. Information, regarding age, sex, weight, American Association of Anesthesiologists(ASA) physical status, Child-Turcotte-Pugh(CTP) classification, indications, preanesthetic problems, endoscopic procedure, successful completion of the procedure, anesthesia time, recovery time, and anesthetic agents, was recorded. Adverse events, including hypotension, hypertension, bradycardia, and hypoxia, were also *** Propofol and sufentanil anesthesia was provided in 182 procedures involving 140 men and 42 women aged 56.1± 11.7 years(range, 25-83 years). The patients weighed 71.4 ± 10.7 kg(range, 45-95 kg) and had ASA physical status classifications of Ⅱ(79 patients) or Ⅲ(103 patients). Ninety-five patients had a CTP classification of A and 87 had a CTP classification of B. Intravenous anesthesia was successful in all cases. The mean anesthesia time was 33.1 ± 5.8 min. The mean recovery time was 12.3 ± 3.7 min. Hypotension occurred in two patients(1.1%, 2/182). No patient showed hypertension during the endoscopic therapy procedure. Bradycardia occurred in one patient(0.5%, 1/182), and hypoxia occurred in one patient(0.5%, 1/182). All complications were easily treated with no adverse sequelae. All endoscopic procedures were completed *** The combined use of propofol and sufentanil injecti

关键词： Endoscopic injection Esophageal varices Propofol Sclerotherapy sufentanil

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Determination of the ED95 of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography

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World Journal of Clinical Cases 2022年第9期10卷 2773-2782页

作者： Yi Zou Na Li Liu-Jia-Zi Shao Fu-Kun Liu Fu-Shan Xue Xing Tao Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Sedation during endoscopic ultrasonography(EUS)poses many challenges and moderate-to-deep sedation are often *** conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with ***,this combination has some *** medication delivery may be an alternative to this sedation *** To determine,by continual reassessment method(CRM),the minimal effective dose of intranasal sufentanil(SUF)when combined with intranasal dexmedetomidine(DEX)for moderate sedation of EUS in at least 95%of patients(ED95).METHODS Thirty patients aged 18-65 and scheduled for EUS were recruited in this *** received intranasal DEX and SUF for *** dose of DEX(1μg/kg)was fixed,while the dose of SUF was assigned sequentially to the subjects using CRM to determine *** sedation status was assessed by modified observer’s assessment of alertness/sedation(MOAA/S)*** adverse events and the satisfaction scores of patients and endoscopists were *** The ED95 was intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,with an estimated probability of successful moderate sedation for EUS of 94.9%(95%confidence interval:88.1%-98.9%).When combined with intranasal 1μg/kg DEX,probabilities of successful moderate sedation at each dose level of intranasal SUF were as follows:0μg/kg SUF,52.8%;0.1μg/kg SUF,75.4%;0.2μg/kg SUF,89.9%;0.3μg/kg SUF,94.9%;0.4μg/kg SUF,98.0%;0.5μg/kg SUF,99.0%.CONCLUSION The ED95 needed for moderate sedation for EUS is intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,based on CRM.

关键词： Moderate sedation Intranasal administration Dexmedetomidine sufentanil Continual reassessment method Endoscopic ultrasonography

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Intranasal sufentanil combined with intranasal dexmedetomidine: A promising method for non-anesthesiologist sedation during endoscopic ultrasonography

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World Journal of Clinical Cases 2022年第23期10卷 8428-8431页

作者： Yong Wang Zhi-Jun Ge Chao Han Department of Anesthesiology The Affiliated Yixing Hospital of Jiangsu UniversityYixing 214200Jiangsu ProvinceChina School of Medical Jiangsu UniversityZhenjiang 212013Jiangsu ProvinceChina

Intranasal sufentanil combined with intranasal dexmedetomidine exhibited an estimated sedation success probability as high as 94.9%,higher satisfaction scores,and only minor adverse events during endoscopic ultrasonog... 详细信息

关键词： Intranasal sufentanil Dexmedetomidine Sedation Endoscopic Ultrasonography

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Impact of thoracic paravertebral block and sufentanil on outcomes and postoperative cognitive dysfunction in thoracoscopic lung cancer surgery

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World Journal of Psychiatry 2024年第6期14卷 894-903页

作者： Dan-Dan Wang Hong-Yu Wang Yan Zhu Xi-Hua Lu Department of Anesthesiology The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer HospitalZhengzhou 450008Henan ProvinceChina

BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(TPVB)or sufentanil(SUF)-based multimodal ***,the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction(POCD)remain *** To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient *** This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January *** receiving SUF-based multimodal analgesia(n=50)and patients receiving TPVB+SUF-based multimodal analgesia(n=57)were assigned to the control group and TPVB group,*** compared the Ramsay Sedation Scale and visual analog scale(VAS)scores at rest and with cough between the two groups at 2,12,and 24 h after *** levels of epinephrine(E),angio-tensin Ⅱ(Ang Ⅱ),norepinephrine(NE),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and S-100 calcium-binding proteinβ(S-100β)were measured before and 24 h after *** Mini-Mental State Examination(MMSE)was administered 1 day before surgery and at 3 and 5 days after surgery,and the occurrence of POCD was monitored for 5 days after *** reactions were also *** There were no significant time point,between-group,and interaction effects in Ramsay sedation scores between the two groups(P>0.05).Significantly,there were notable time point effects,between-group differences,and interaction effects observed in VAS scores both at rest

关键词： Thoracic paravertebral block sufentanil Thoracoscope Radical resection of lung cancer Postoperative cognitive dysfunction

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sufentanil reduces emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl

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Chinese Medical Journal 2011年第22期124卷 3682-3685页

作者： LI Jun HUANG Zhi-lian ZHANG Xu-tong LUO Ke ZHANG Zhan-qin MAO Yi ZHUANG Xiao-biao LIAN Qing-quan CAO Hong Department of Anesthesiology Second Affiliated Hospital ＆ Yuying Children＇s Hospital of Wenzhou Medical College Wenzhou Zhejiang 325027 China

Background Emergence agitation is a common problem in pediatric anesthesia, especially after sevoflurane induction and maintenance anesthesia. The purpose of this study was to investigate the effect of sufentanil to reduce emergence agitation after sevoflurane anesthesia in children undergoing adenotonsillectomy compared with fentanyl. Methods One hundred and five children, aged 3-11 years, were randomly allocated to receive normal saline （control group）, sufentanil 0.2 pg/kg （S2） or fentanyl 2 pg/kg （F2） 1 minute after loss of the eyelash reflex. Anesthesia was induced and maintained with sevoflurane. Time to tracheal extubation, recovery time, Paediatric Anesthesia Emergence Delirium （PAED） scale, and emergence behavior were assessed. Results The incidence of severe agitation was significantly lower in $2 and F2 groups vs. the control group, 4/32 and 15/34 vs. 24/34 respectively, （P=0.002, 0.009, respectively）. PAED scales were significantly different among three groups （P=0.007）, and lower in the S2 and F2 groups than in the control group （P=0.007 and P=-0.025, respectively）. And the incidence of severe agitation and the PAED scale score was significantly different between the $2 and F2 groups （P=-0.007, P=0.019, respectively）. Time to tracheal extubation and recovery time were similar in all three groups. Conclusions Administration of sufentanil at 0.2 IJg/kg after induction of anesthesia reduced emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl. This was without delaying the recovery time or causing significant hypotension.

关键词： anesthesia sufentanil fentanyl emergence agitation children

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Two-stage analysis of pharmacokinetics of sufentanil administered by target-controlled infusion in Chinese patients

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Chinese Medical Journal 2009年第17期122卷 1979-1984页

作者： ZHAO Yan DUAN Jing-li WU Xin-min JIANG Jian-yu LU Wei ZHANG Li-ping WANG Jun MENG Xiu-li XU Chuan-ya JIA Dong-lin LIU Wei SHENG Xiao-yan Department of Anesthesiology (Zhao Y Jiang JY Zhang LP WangJ Meng XL Xu CY and Jia DL) Department of Pharmacy Peking University Third HospitalBeijing 100191 China Department of Anesthesiology Peking University First HospitalBeijing 100034 China School of Pharmaceutical Sciences Peking University Beijing100191 China

Background sufentanil is a suitable choice for target-controlled infusion （TCI） because of its shorter context-sensitive half-time. The current study was to estimate the pharmacokinetics of sufentanil TCI in Chinese patients using the two-stage analysis. Methods Twelve adult patients with American Society of Anesthesiologists （ASA） physical status I or II undergoing elective surgery under general anesthesia were included. Anesthesia was induced with propofol, rocuronium and sufentanil administered by TCI lasting for 30 minutes, with target effect-site concentration of sufentanil 4 or 6 ng/ml. Frequent arterial blood samples （1.5 ml） were taken during and up to 24 hours after sufentanil TCI. Before the end of surgery, another arterial blood sample （1.0 ml） was drawn for the blood-gas analysis. Plasma sufentanil concentrations were determined by liquid chromatography-tandem mass spectrometry （limit of quantitation was 5 pg/ml）. The data were analyzed with the two-stage approach, linear regression and correlation analysis. Results The pharmacokinetics of sufentanil TCI were adequately described by a three-compartment model. The variables were derived as follows： the volume of central compartment （V1） was 5.4 L, volume of distribution at steady-state （Vdss） was 222.6 L, metabolic clearance （CI1） was 0.84 L/min and elimination half-life （t~/2y） was 389 minutes. Patients＇ age, gender and PaCO2 correlated significantly with the pharmacokinetic parameters. The Vdss, volume of slowly equilibrating compartment （V3） and t1/2 y increased, and rapid distribution clearance （012） decreased with increasing patient age. Male patients had larger values of Vdss, volume of rapidly equilibrating compartment （V2） and V3 than female patients. The Vdss and V3 increased with higher PaCO2 values. There were no significant correlations between the pharmacokinetic variables and body weight, height, lean body mass, plasma albumin, sufentanil dose, duration of surgery, pH or base excess of blood

关键词： anesthesia sufentanil pharmacokinetics target-controlled infusion two-stage analysis

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Dexmedetomidine-midazolam versus sufentanil-midazolam for Awake Fiberoptic Nasotracheal Intubation： A Randomized Double-blind Study

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Chinese Medical Journal 2015年第23期128卷 3143-3148页

作者： Cheng-Wen Li Yan-Dong Li Hai-Tao Tian Xian-Gang Kong Kui Chen Department of Anesthesiology Jining No. 1 People's Hospital Jining Shandong 272011 China Department of Anesthesiology Affiliated Hospital of Jining Medical University Jining Shandong 272029 Chin

Background： Awake fiberoptic intubation （AFOI） is usually performed in the management of the predicted difficult airway. The aim of this study was to evaluate the feasibility of dexmedetomidine with midazolam （DM） and sufentanil with midazolam （SM） for sedation for awake fiberoptic nasotracheal intubation. Methods： Fifty patients with limited mouth opening scheduled for AFOI were randomly assigned to two groups （n = 25 per group） by a computer-generated randomization schedule. All subjects received midazolam 0.02 mg/kg as premedication and airway topical anesthesia with a modified ＂spray-as-you-go＂ technique. Group DM received dexmedetomidine at a loading dose of 0.5 μg/kg over 10 min followed by a continuous infllsion of 0.25 μ***^-1.h ^-1, whereas Group SM received sufentanil at a loading dose of 0.2 μg/kg over 10 rain followed by a continuous infusion of 0.1 μ***^-1.h ^-1. As necessary, since the end of the administration of the loading dose of the study drug, an additional dose ofmidazolam 0.5 mg at 2-min intervals was given to achieve a modified Observers＇Assessment of Alertness/Sedation of 2-3. The quality of intubation conditions and adverse events were observed.Results： The scores of ease of the AFOI procedure, patient＇s reaction during AFOI, coughing severity, tolerance after intubation, recall of the procedure and discomfort during the procedure were comparable in both groups （z = 0.572, 0.664, 1.297, 0.467, 0.895, and 0.188, respectively, P 〉 0.05）. Hypoxic episodes similarly occurred in the two groups, but the first partial pressure of end-tidal CO, after intubation was higher in Group SM than that in Group DM （45.2 ± 4.2 mmHg vs. 42.2 ±4.3 mmHg, t = 2.495, P 〈 0.05）. Conclusions： Both dexmedetomidine and sufentanil are effective as an adjuvant for AFOI under airway topical anesthesia combined with midazolam sedation, but respiratory depression is still a potential risk in the sufentanil regimen.

关键词： Awake Fiberoptic lntubation: Conscious Sedation: Dexmedetomidine Midazolam sufentanil

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Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients:a meta-analysis of randomized controlled trials

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Chinese Medical Journal 2023年第1期136卷 45-52页

作者： Xixia Feng Pingliang Yang Zaibo Liao Ruihao Zhou Lu Chen Ling Ye Department of Pain Management West China HospitalSichuan UniversityChengduSichuan 610041China Department of Anesthesiology The First Affiliated Hospital of Chengdu Medical CollegeChengduSichuan 610500China The Center of Gerontology and Geriatrics West China HospitalSichuan University/West China School of NursingSichuan UniversityChengduSichuan 610041China

Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant ***-controlled intravenous analgesia(PCIA)is a recommended solution,where oxycodone has depicted unique advantages in recent ***,controversy still exists in clinical practice and this study aimed to compare two drugs in ***:We performed a literature search in PubMed,Embase,the Cochrane Central Register of Controlled Trials,Web of Science,Chinese National Knowledge Infrastructure,Wanfang,and VIP databases up to December 2020 to select specific randomized controlled trials(RCTs)comparing the efficacy of oxycodone with sufentanil in *** analgesic effect was the primary outcome and the secondary outcome included PCIA consumption,the Ramsay sedation scale,patients’satisfaction and side ***:Fifteen RCTs were included in the *** with sufentanil,oxycodone showed lower Numerical Rating Scale scores(mean difference[MD]=-0.71,95%confidence interval[CI]:-1.01 to-0.41;P<0.001;I^(2)=93%),demonstrated better relief from visceral pain(MD=-1.22,95%CI:-1.58 to-0.85;P<0.001;I^(2)=90%),promoted a deeper sedative level as confirmed by the Ramsay Score(MD=0.77,95%CI:0.35-1.19;P<0.001;I^(2)=97%),and resulted in fewer side effects(odds ratio[OR]=0.46,95%CI:0.35-0.60;P<0.001;I^(2)=11%).There was no statistical difference in the degree of patients'satisfaction(OR=1.13,95%CI:0.88-1.44;P=0.33;I^(2)=72%)and drug consumption(MD=-5.55,95%CI:-14.18 to 3.08;P=0.21;I^(2)=93%).Conclusion:Oxycodone improves postoperative analgesia and causes fewer adverse effects,and could be recommended for PCIA,especially after abdominal ***:PROSPERO;https://***/PROSPERO/;CRD42021229973.

关键词： Oxycodone sufentanil Patient-controlled intravenous analgesia Pain Postoperative

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Clinical evaluation of target controlled infusion system for sufentanil administration

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Chinese Medical Journal 2009年第20期122卷 2503-2508页

作者： ZHAO Yan ZHANG Li-ping WU Xin-min JIANG Jian-yu DUAN Jing-li HU Yong-fang LI Min LIU Wei SHENG Xiao-yan NI Cheng XU Mao GUO Xiang-yang Department of Anesthesiology Peking University Third Hospital Beijing 100191 China Department of Anesthesiology Peking University First Hospital Beijing 100034 China Department of Pharmacy Peking University Third Hospital Beijing 100191 China

Background sufentanil target controlled infusion （TCI） provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia during perioperative period. This study evaluated the accuracy and feasibility of TCI system for sufentanil at high concentrations in Chinese surgical patients. Methods Twelve low risk adult patients undergoing elective surgery under general anesthesia were included in this study. sufentanil was administered with a specific TCI system incorporating the population pharmacokinetic data of sufentanil previously reported, using a target effect-site concentration of sufentanil 4 or 6 ng/ml. sufentanil TCI duration was 30 minutes. Frequent arterial blood samples were taken during and up to 24 hours after sufentanil TCI for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry. The changes of circulatory system function during the procedure, recovery profile and adverse effects were recorded. Measured plasma sufentanil concentrations were compared with the values predicted by the TCI system. The bias （median performance error, MDPE）, precision （median absolute performance error, MDAPE） and wobble （variability of performance error） of the sufentanil TCI system were determined. Results All patients had stable cardiovascular variables during induction and maintenance of anesthesia. Time to eye opening and extubation were （5.6±1.7） minutes when TCI set to 4 ng/ml and （7.2±2.3） minutes when set to 6 ng/ml. There was no episode of agitation, muscle rigidity or intraoperative awareness. The bias （MDPE）, precision （MDAPE） and wobble of the sufentanil TCI system were -3.7%, 18.9% and 19.6% respectively during TCI, and the MDPE, MDAPE and wobble were -29.1%, 31.7% and 15.0% respectively after TCI （up to 8 hours）. Conclusions The TCI system programmed for sufentanil at 4 or 6 ng/ml was considered acceptable for clin

关键词： anesthesia analgesic sufentanil target-controlled infusion tandem mass spectrometry

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Pupillary response in patients receiving intrathecal sufentanil

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Chinese Medical Journal 2007年第14期120卷 1274-1276页

作者： WANG Yi-chun GUO Qu-lian WANG E ZHONG Tao HUANG Chang-sheng PENG Jing Department of Anesthesiology Hunan Tumor Hospital Changsha 410006 China Department of Anesthesiology Xiangya Hospital of Central South University Changsha 410008 China

pupillary constriction occurs with intravenous administration of opioids such as ***, few studies have investigated the pupillary effects of intrathecal （IT） sufentanil. It has previously been demonstrated that the cephalad spread within the cerebrospinal fluid of IT sufentanil results in side effects. There are two principal findings of the present study：（1） spinal sufentanil combined with low-dose of bupivacaine in patients with lower abdominal or lower extremity procedures induces a dose-dependent pupillary constriction that is far more sensitive than other centrally-mediated side effects; （2） the pupillary effect of IT sufentanil correlates closely with the adequacy of spinal anesthesia.

关键词： pupillary constriction intrathecal injections sufentanil anesthesia

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