Observation of the safety and efficacy of alfentanil and sufentanil in anesthesia for elderly patients undergoing colorectal surgery: A prospective randomized controlled study

Abstract

Objective: This paper aims to explore the safety and efficacy of alfentanil in anesthesia for laparoscopic colorectal surgery.  Methodology: This study was designed as a prospective study. Eighty elderly patients who underwent laparoscopic colorectal surgery between February 2023 to February 2025 were selected and randomly divided into an alfentanil group and a sufentanil group, with 40 patients in each group. The LIDCOrapid non-invasive hemodynamic monitor was used to record the heart rate (HR) and mean arterial pressure (MAP) of patients at the pre-anesthesia baseline (T0), before tracheal intubation (T1), one minute after tracheal intubation (T2), three minutes after tracheal intubation (T3), and five minutes after tracheal intubation (T4). The incidence of intraoperative adverse reactions and the use of vasoactive drugs were recorded, and the recovery of patients after the discontinuation of anesthetic drugs was compared. Results: Compared with the alfentanil group, the MAP level and HR in the sufentanil group fluctuated more significantly at T1, T2, and T3 (P < 0.05). The incidence of hypotension and the use of ephedrine were higher in the sufentanil group than in the alfentanil group (P < 0.05). The eye-opening time, orientation recovery time, and time out of the post-anesthesia care unit (PACU) in the sufentanil group were longer than those in the alfentanil group (P < 0.05). Conclusion: Compared with sufentanil induction, alfentanil administration during laparoscopic colorectal surgery for elderly patients can more effectively reduce hemodynamic fluctuations, decrease the use of intraoperative active drugs, and ensure rapid awakening without increasing postoperative adverse reactions - that is, it provides a higher level of comfort.