Influence of target controlled infusion of etomidate and sufentanil on hemodynamic stability during general anesthesia induction and endotracheal intubation in elderly patients

Objective To study the effect of balanced anesthesia with different concentration of chamber etomidate and sufentanil (target controlled infusion,TCI) on hemodynamic stability during general anesthesia induction and endotracheal intubation in elderly patients. Methods Fifty two patients undergoing elective surgery and general anesthesia were enrolled and randomly divided into three groups according to the different target concentration of etomidate:low concentration group (target concentration 0.40 μg/L,17 cases),moderate concentration group (0.50 μg/L,17 cases) and high concentration group (0.60 μg/L,18 cases).The mean arterial pressure (MAP),heart rate (HR),bispectral index (BIS),cardiac output (CO),cardiac index (CI) and stroke volume (SV) were determined at T0(prior to the induction of general anesthesia),T1(chamber and plasma etomidate concentration balanced),T2(chamber and plasma sufentanil concentration balanced),T3(during endotracheal intubation),T4(1 min after intubation),T5(2 min after intubation) and T6(3 min after intubation) time points.The total amount of etomidate and sufentanil were recorded.The data were compared among different groups. Results ①HR decreased while CO and SV increased in the high concentration group at each time points when compared with the data at T0,P<0.05;At T2 point,HR,CO and CI were all decreased in the three groups (P<0.05);At T3 and T4 point,CO,CI and SV were all increased (P<0.05),the value of MAP,HR,CO,CI and SV in all three were higher than those at T2 point (P<0.05);At T5 point,MAP decreased in all three groups (P<0.05),HR,CO,CI and SV decreased only in the medium and high concentration groups (P<0.05);At T6 point,MAP decreased in all three groups (P<0.05),CO,CI and SV decreased only in the high concentration groups (P<0.05);②There was no significant in the average total dose of sufentanil during induction among the three groups (P>0.05),but significant for etomidate. Conclusion The target controlled infusion of 0.50 μg/L of etomidate and 0.4 μg/L of sufentanil will minimize the affection on hemodynamic stability during general anesthesia induction and endotracheal intubation in elderly patients.