Clinical Study Of Sufentanil In Myocardial Protection Of Patients Performed Off-pump Coronary Artery By Pass Grafting

Objective To explore the effects of myocardial protection of sufentanil on patients performed off-pump coronary artery bypass grafting.Method60patients,52-75years in age, with off-pump coronary artery bypass graft selective operation, the ASA II or III, were randomly divided into the Fentanyl group (Group F) and sufentanil group (S),(n=30each). Fentanyl10ug/kg was used in group F, Sufentanil1ug/kg in group S, during anesthesia induction. Fentanyl8ug/kg was used to keep Anesthesia in group F, Sufentanil0.8ug/kg in group S, at skin incision, in sternotomy, in clamping aortic sidewall,and the completion of operation respectively.The radial artery blood samples were obtained at these time points:before induction of anesthesia(T0), the completion of the suture blood vessels (T1), the completion of operation (T2),8,16,24hours after operation(T3, T4, T5).10ml serum in both groups cases were separated, which were measured interleukin6(IL-6), interleukin10 (IL-10), creatine kinase isoenzyme (CK-MB), cardiac troponin (cTnI) concentration and activity of superoxide dismutase enzyme (SOD) by enzyme-linked immunosorbent assay. The MAP and HR was recorded at these time points:before induction of anesthesia, After the induction and Intubation of immediate,5minutes after intubation, in sternotomy and the end of operation. Time to regain consciousness, pull out endotracheal tube and ICU stay was also recorded.Results The concentration of cTnI in group F were significantly lower than in group S at T4-5(p<0.05), the concentration of IL-6were lower at T1-4(p<0.05), the concentration of IL-10were higher at T1-4(p<0.05),the activity of SOD were higher at T1-3(p<0.05). The MAP and HR were significantly lower (p<0.05)in group S than that group F after Intubation of immediate,5minutes after intubation, in sternotomy and the end of operation. Time to regain consciousness, pull out endotracheal tube and ICU stay was significantly lower (p<0.05)in group S.Conclusion Sufentanil have the effect of myocardial protection in the off-pump coronary artery bypass grafting. Hemodynamic has better stability, whose mechanism is in connection with anti-inflammatory, scavenging free radicals, reducing oxidative stress.