| Objective:To compare the clinical common equivalent dose of sufentanil and fentanyl whether the existence of myocardial protection through detecting perioperative changes of cardiac troponin I in adult mitral valve replacement.Methods:Select 20 adult patients with rheumatic mitral valve disease required to undergo valve replacement, according to the different opioid drugs they were randomly divided into fentanyl group (F group,n=10) and sufentanil group (S group,n=10).Both groups were given continuous intravenous infusion method. To maintain MAP at about 60-80mmHg and adjust the infusion rate according to operative procedure and patients with circulation. From starting the anaesthesia to aortic clamping, total dose of fentanyl was 35μg/kg, sufentanil reached a total of 5μg/kg; From aortic clamping to immediate moment of aortic opening, total dose of fentanyl was 14μg/kg, and sufentanil was 2μg/kg;from aottic opening to the end of surgery, total dose of fentanyl was 10μg/kg,and sufentanil was 1.4μg/kg.The surgery. Blood samples were collected in both groups respectiveiy before induction of anesthesia(To), before the CPB(T1), aortic opening 30min(T2), CPB stop 4h(T3), CPB stop 24h(T4),then the cTnI in plasma of all blood sample was tested.In surgery, the heart rate (HR), mean arterial pressure (MAP) and other hemodynamic parameters,bypass time,aortic cross clamp time and operation time were recorded.Results:CTnI at To, both groups were within the normal range, no significant difference (p> 0.05);T1 were higher when compared with To, (p<0.05), the two groups showed no significant difference (p> 0.05); T2, T3, T4 were higher when compared with To, there was a significant difference (p<0.01),F group was significantly higher than the S group, with significant difference (p<0.05).Conclusion:Compared with equivalent doses of fentanyl, sufentanil used in adult cardiopulmonary bypass has better myocardial protection. |
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