Sufentanil

After arrival in the anesthesia induction room, an intravenous infusion was implemented, and the noninvasive monitoring of vital parameters was applied. General anesthesia was induced by intravenous injection of sufentanil (Hameln Pharma GmbH, Hameln, Germany) 0.4–0.6 µg kg⁻¹, 2–3 mg kg⁻¹ propofol (Fresenius Kabi Deutschlang GmbH, Bad Homburg, Germany), and 0.5–0.9 mg kg⁻¹ rocuronium (Inresa Arzneimittel GmbH, Freiburg, Germany). After the intubation of the trachea, a radial arterial line and a three-lumen central-venous catheter were inserted. General anesthesia was maintained with sevoflurane (AbbVie Deutschland GmbH, Ludwigsburg, Germany) (0.7–1.0 MAC) and the intravenous boli of sufentanil and rocuronium at the discretion of the anesthesiologist. Norepinephrine (Cheplapharm Arzneimittel GmbH, Greifswald, Germany) and glycerol trinitrate (Carinopharm GmbH, Elme, Germany) were used to stabilize the blood pressure. After the end of the surgery, the patients were promptly extubated.

In the operating room, general anesthesia is induced with 2 to 3 mg·kg^-1 propofol (Fresenius Kabi, Zeist, the Netherlands), sufentanil (Bipharma, Almere, the Netherlands) for analgesia and 0.6 mg·kg^-1 rocuronium (Fresenius Kabi, Zeist, the Netherlands) for paralysis. The trachea is intubated, and the lungs are mechanically ventilated with pressure regulated volume control. After induction, general anesthesia is maintained with sevoflurane (AbbVie, Hoofddorp, the Netherlands) at a minimal alveolar concentration (MAC) of 1 and, when needed (based on signs of pain), is supplemented by an additional bolus of sufentanil. An arterial line is inserted into the right or left radial artery. A right jugular tri-lumen central line is inserted when deemed necessary. A double lumen gastric cannula is inserted. A urinary catheter is inserted. Cefazoline (Kefzol™) 2 g and metronidazol (Flagyl™) 500 mg are given prior to incision. Cefazoline is repeated after 6 h if the surgery is ongoing.