Effect of the Aortic Root Infusion of Sufentanil on Ischemia-Reperfusion Injury in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Clinical Trial

  • Mohammad Bagher Khosravi Department of Anesthesia, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Mahdi Kahrom Department of Cardiovascular Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Mahdi Tahari Division of Cardiac Perfusion, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Kambiz Alizadeh Mail Department of Cardiovascular Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Ghasem Soltani Department of Anesthesia, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Mohammad Ali Ghanad Department of Anesthesia, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Keywords:
Cardiopulmonary bypass, Cardiac surgical procedures, Sufentanil, Ischemic postconditioning, Reperfusion injury

Abstract

Background: Ischemic postconditioning is a novel strategy for attaining cardioprotection. Remarkable evidence from various in vitro and in vivo animal and human studies have shown significant opioid-induced cardioprotection against myocardial ischemia/reperfusion (I/R) injury. The purpose of this study was to assess the cardioprotective effect of sufentanil against I/R injury after on-pump coronary artery bypass grafting (CABG).
Methods: Between June 2016 and July 2017, 80 consecutive patients with triple-vessel disease undergoing on-pump CABG were enrolled in this prospective randomized study. The patients assigned to the sufentanil group received a single dose of sufentanil (0.2 μg/kg diluted with 50 cc of saline) 5 minutes before the removal of the aorta cross-clamp, with the sufentanil injected via a cardioplegia needle into the aortic root. In the control group, the same volume of normal saline was injected as a placebo. Cardiac enzymes, the inotrope score, and the outcome data were compared between the 2 groups.
Results: The mean age of the patients was 60.48±7.50 years (range=41–69 y), and men comprised 65.0% of the study population. The levels of CK-MB and cardiac troponin I were significantly lower in the sufentanil group (P<0.001). The amount of inotrope use (P<0.001), the incidence of atrial fibrillation (P=0.014), electrical shock (P=0.007), and the mechanical ventilation time (P<0.001) decreased in the sufentanil group compared with the control group. However, the use of intra-aortic balloon pumps (P=0.247) and the ICU length of stay (P=0.867) were not significantly different between the 2 groups.
Conclusion: The injection of a single dose of sufentanil into the aortic root prior to aorta cross-clamp removal diminished cardiac injury during on-pump CABG in our patients.

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Published
2019-10-19
How to Cite
1.
Bagher Khosravi M, Kahrom M, Tahari M, Alizadeh K, Soltani G, Ghanad MA. Effect of the Aortic Root Infusion of Sufentanil on Ischemia-Reperfusion Injury in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Clinical Trial. J Tehran Heart Cent. 14(4):177-182.
Section
Original Article(s)