| Objective : To investigate the effects and mechanism of ischemic postconditioning with morphine for myocardium preservation in children during open heart surgery.Methods:Forty-five patients who confer congenital heart disease were randomly divided into three groups, group A(n=15, morphine 0.05mg/kg), group B (n=15, morphine 0.1mg/kg) and group C(n=15, saline).All patients'aortas were routinely clamped during cardiopulmonary bypass(CPB).3 minuts before open aorta , morphine 0.05mg/kg , morphine 0.1mg/kg and the same volume of saline were injected to patients in three groups respectively by aorta.The blood samples were taken from central venous catheter for detection of haematocrit (HCT),cardiac troponin I (cTnI), creatine kinase-MB(CK-MB),superoxide dismutase(SOD),macondialdehyde(MDA) and Tumor necrosis factor-a(TNF-a) at various time points,such as, before operation(T1),at aorta opening(T2) immediately, and at 1h (T3),3h(T4),24h(T5) , and 72h(T6) after aorta opening,respectively.We observed and recorded the rate of spontaneous resuscitation, the incidence of arrhythmia,the doses of inotropic agents,the duration of ventilation ,the days of staying in CICU and the hospitalization days after operation.Results: The levels of cTnI,CK-MB,MDA and TNF-aat T2 and T6 (P<0.05) in group C were higher than those in group A and group B.Compared with group C,the doses of inotropic agents, the duration of ventilation ,the days of staying in CICU in group A and group B were lower and shorter (P<0.05,respectively).But the rate of spontaneous resuscitation was higher (P<0.05).The incidence of arrhythmia and the hospitalization days after operation in there groups were not different.Conclusions: This study demonstrates that ischemic postconditioning with morphine could provide protection for injured myocardium in children during open heart surgery,and the mechanism may be associated with antioxidant and anti-inflammatory.
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