Effect Of Sufentanil Postconditioning On Myocardial Ischemia-reperfusion Injury In Patients Undergoing Off-pump Coronary Artery Bypass Graft Surgery

Objective:To investigate the effect of sufentanil postconditioning on myocardial ischemia/reperfusion injury in patients undergoing off-pump coronary artery bypass graft surgery.Methods:From December 2014 to July 2016,45 patients with ASA III-?(36 males and 9females)were initially elected for off-pump coronary artery bypass(OPCAB)surgery in General Hospital of Ningxia Medical University.While 5 patients were denied based on the exit criteria.The remained 40 patients were divided two groups: sufentanil group(group S,n=20)and sufentanil postconditioning group(group SI,n=20).The patients received 2 min of infusion via central vein 5min before anterior descending artery opening.In group S,equal volume saline was injected,in group SI 0.2ug·kg-1of sufentanil was injected.Blood samples were collected during the following time points: before induction of anesthesia(T1),opening anterior descending artery(T2),end of the operation(T3)and 6h after the operation(T4).Plasma concentrations of cardiac troponin-I(cTnI)and heart-type fatty acid binding protein(h-FABP)were measured at T1,T2,T3,T4 with enzyme-linked immunosorbent assay.length of ICU stay,length of hospital stay,extubation time,24 hour postoperative myocardial contractility score,dosage of vasoactive drugs during operation and drainage volume 24 hours after operation were recorded.Results:There were no difference of age,height,and body weight during the two groups.There were no difference of length of ICU stay,length of hospital stay,extubation time,dosage of vasoactive drugs during operation and drainage volume 24 hours after operation.The plasma cTnI concentrations were significantly lower at T3?T4 in group SI than them in groupS(P<0.05).The plasma h-FABP concentrations were significantly lower at T4 in group SI than them in group S(P<0.05);In group SI,the plasma cTnI concentrations were significantly lower at T4 and T3 than at T1 and T2.(P<0.05),the plasma h-FABP concentrations were significantly lower at T4 than at T1-3.(P<0.05).24-hour postoperative myocardial contractility score was significantly low in group SI than in groups S at T4(P<0.05).Conclusion:Sufentanil postconditioning may be relieve I/R injury in patients undergoing off-pump coronary artery bypass graft surgery.