Comparison of intraoperative wake-up test in patients undergoing scoliosis surgery with different anesthesia methods

Abstract

Objective To compare the intraoperative wake-up test in patients undergoing scoliosis surgery with different anesthesia methods.Methods Forty ASA Ⅰ patients aged 13-18 yr with body mass index ＜ 30 kg/m2 scheduled for scoliosis surgery were randomly divided into 2 groups ( n =20 each): propofol combined sufentanil anesthesia group (group P) and sevoflurane combined sufentanil anesthesia group (group S).Anesthesia was induced with target-controlled infusion of sufentanil(target effect-site concentration 0.5 ng/ml),and iv injection of etomidate 0.3 mg/kg in both groups.Tracheal intubation was facilitated with 0.15 mg/kg cisatracurium when patients lost consciousness.The patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (target end-tidal concentration 0.8％-1.5％ ) in group S,and target-controlled infusion of propofol (target plasma concentration 3-5 μg/ml) in group P,and target-controlled infusion of sufentanil (target effect-site concentration 0.2-0.3 ng/ml),and iv infusion of cisatracurium 0.1 mg· kg-1· h-1 in both groups.BIS value was maintained at 40-60.Cisatracurium administration was terminated and target effect-site concentration of sufentanil decreased to 0.1 ng/ml before wake-up test,5 min later,sevoflurane and propofol administration were terminated,and 5 min later wake-up test was performed.MAP and HR were recoreded during wake-up test.The wake-up time and advers effect (bucking,restlessness and awareness)were recorded.Results The wake-up time was significantly shorter in group S than in group P( P ＜ 0.05).MAP and HR were in normal range during wake-up test in both groups,and bucking,restlessness and awareness were not found in both groups.Conclusion Target-controlled inhalation of ssvoflurane combined with sufentanil can be safely and effectively used for intraoperative wake-up test in patients undergoing scoliosis surgery,and the wake-up time is shorter than that with propofol combined sufentanil,and it is an apporiate anesthetic technique for the intraoperative wake-up test. Key words: Anesthetics, inhalation; Drug delivery systems; Sufentanil; Scoliosis