Comparison of the effects of fentanyl and sufentanyl on haemodynamy and recovery parameters during TIVA in craniotomy [Kraniyotomilerde total i·ntravenöz anestezi uygulamasinda kullanilan sufentanil ve fentanilin hemodinami ve derlenmeye etkilerinin karşilaştirilmasi]

Aim: We aimed to compare the effects of fentanyl and sufentanyl on haemodynamy and recovery parameters during TIVA in patients undergoing craniotomy. Materials and Methods: Thirty ASA I-II patients aged between 18 to 60 years who underwent elective craniotomy were randomly divided into two groups. Anesthesia induction was provided by intravenous atropine 0.1 mg, kg-1, propofol 2-3 mg kg-1, vecuronium 0.1 mg kg -1 in both groups. 2 µg kg-1 fentanyl was administered intravenously to the patients in fentanyl group, 1 µg kg-1 iv sufentanyl was given in sufentanyl group during anesthesia induction. Anaesthesia was maintained with % 50 O2 + air and 5-7 mg kg-1 propofol infusion in both groups with additional sufentanyl infusion at the rate of 0.3 pg kg-1 h-1 in the sufentanyl group and 1 µg kg-1 h-1 fentanyl in the fentanyl group. Haemodynamic variables were recorded during anesthesia till 240 min after extubation, including just before induction, before and after intubation, before and after pin holder insertion, before surgical incision and after surgical incision, Results: In fentanyl group when compared with sufentanyl group, mean arterial blood pressures were significantly higher following intubation (p=0.001), pin holder insertion (p=0.001) and surgical incision (p=0.020). In addition in fentanyl group mean arterial blood pressures increased significantly, both after intubation (p=0.001) and extubation (p=0.023) when compared with previous values. In fentanyl group, heart rates increased significantly, both after intubation (p=0.013) and extubation (p=0.017) while in sufentanyl group heart rates increased significantly only after extubation (p=0.038) when compared with previous values. Time needed for eye opening (P=0.009) and hand gripping (p=0.019) were significantly shorter in sufentanyl group. Conclusion: We conclude that in patients undergoing craniotomy, sufentanyl administrated at doses used for TIVA is more effective in depressing the intraoperative haemodynamic response than fentanyl and provides more rapid recovery time than fentanyl