COMPARISON BETWEEN HIGH-DOSE SUFENTANIL-OXYGEN AND HIGH-DOSE FENTANYL-OXYGEN FOR NEUROANAESTHESIA

The cardiovascular responses to anaesthesia, neurosurgery andthe postoperative administration of naloxone were studied in20 patients. Ten patients were anaesthetized with sufentanil20 µ kg^–1 and 10 with fentanyl 100 µg kg^–1,and oxygen. At 30-min intervals, sufentanil 50 µg or fentanyl250 µg was given to maintain anaesthesia. Mean arterialpressure and heart rate did not increase following intubation,incision of the scalp or infusion of naloxone. Because of inadequateanaesthesia, thiopentone was administered at the end of surgeryto one patient who had received sufentanil and seven patientswho received fentanyl. Apart from one patient in each groupthe tracheal tubes were removed within 1 h of the start of theadministration of naloxone. Recall of tracheal intubation orsurgery was not reported by any patient. High-dose sufentanil-oxygenanaesthesia, like high-dose fentanyl- oxygen anaesthesia, wassatisfactory for use in neurosurgery. However, high-dose narcoticanaesthesia, followed by the postoperative administration ofnaloxone, requires that skilled nursing care be available formany hours after surgery.