Abstract
BackgroundTo determine the median effective concentration of sufentanil as an analgesic during wake-up tests after sevoflurane anesthesia during surgery for adolescent idiopathic scoliosis (AIS).MethodsThis is a randomised controlled trial. Sixty patients aged 13–18 years scheduled for AIS surgery were randomized into six groups of 10 patients each to receive target effect-site concentrations of sufentanil of 0.19, 0.1809, 0.1723, 0.1641, 0.1563, and 0.1489 ng/ml (target concentration ratio, 1.05). Wake-up time was recorded. Median EC50 and 95% confidence interval (CI) for sufentanil target-controlled infusion (TCI) were determined using Kärber’s method. The primary outcome was median EC50 for sufentanil TCI as an analgesic during the wake-up test after sevoflurane anesthesia during surgery for AIS.ResultsThe EC50 and 95% CI of sufentanil TCI were 0.1682 ng/ml and 0.1641 ~ 0.1724 ng/ml, respectively.ConclusionsThe EC50 of sufentanil TCI was 0.1682 ng/ml (95% CI: 0.1641 ~ 0.1724 ng/ml) during sevoflurane anesthesia in adolescents undergoing surgery for idiopathic scoliosis with intraoperative wake-up tests.Trial registrationClinicaltrials.gov identifier: ChiCTR-TTRCC-12002696.
Highlights
To determine the median effective concentration of sufentanil as an analgesic during wake-up tests after sevoflurane anesthesia during surgery for adolescent idiopathic scoliosis (AIS)
Following approval by the ethics committee of Kunming General Hospital of the Chengdu Military Area (Trial registration number: ChiCTR-TTRCC-12002696) and written, informed consent from the patients and their parents, we enrolled consecutive ASA physical status I patients, aged 13–18 years, scheduled to undergo surgery for AIS. Sixty patients in this double-blinded study were randomized to 6 groups (n = 10) according to a table of random numbers, since 5 ~ 20 patients per group are thought sufficient for the BehrensKärber method
Sufentanil has been found to result in better analgesia and more stable hemodynamics [15], and the combination of sufentanil and the inhaled anesthetic sevoflurane has been found to produce synergistic effects in the induction of anesthesia [16].Sufentanil has been found to improve the quality of awakening [15] and to reduce the likelihood of postoperative complications [17]
Summary
To determine the median effective concentration of sufentanil as an analgesic during wake-up tests after sevoflurane anesthesia during surgery for adolescent idiopathic scoliosis (AIS). Median EC50 and 95% confidence interval (CI) for sufentanil target-controlled infusion (TCI) were determined using Kärber’s method. The primary outcome was median EC50 for sufentanil TCI as an analgesic during the wake-up test after sevoflurane anesthesia during surgery for AIS. Adolescent idiopathic scoliosis (AIS) is one of the most common structural spinal deformities in the coronal plane affecting young people. The most important neurological complication during surgery for AIS is iatrogenic spinal cord injury. The wake-up test is the standard neurophysiological procedure for the intraoperative detection of emerging spinal cord injuries during the surgical correction of AIS [3].
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