The influence of opioid to troponin I, and IL-6 in patients undergoing cardiac surgery

Abstract

Objective To investigate the change of cardiac troponin Ⅰ (cTnⅠ), interleukin (IL)-6 in patients undergoing cardiac valve replacement and compare the degrees of fentanil, sufentanil, and remifentanil on myocardial protection and inhibiting effect of inflammatory. Methods Forty-eight patients, undergoing cardiac valve replacement, were randomly divided into three groups (n=16): remifentanil (group R), sufentanil (group S), and fentanil (group F). All the patients were total intravenous anesthesia of midazolam, opioid, vecuronim, and propofol. Different opioids were used in each group. Group R was induced with remifentanyl 1~2 μg/kg and maintained at a rate of 1~4 μg/(kg·min). Group S was induced with sufentanyl 1~2 μg/kg and maintained at a rate of 1~4 μg/(kg·h). Group F was induced with fentanyl 5~10 μg/kg and maintained at a rate of 10~30 μg/(kg·h). Blood samples were taken before anesthesia (T0), twenty minutes after aortic declamping (T1), the end of operation (T2), 6 h (T3), and 24 h (T4) after cardiopulmonary bypass (CPB) for determination of plasma concentration of troponinI and IL-6. Results Compared to T0, cTnⅠ and IL-6 in three group at T1, T2, T3 were significantly higher (P<0.05), cTnⅠ reached the peak level at T4 (P<0.05), IL-6 reached the peak level at T3(P<0.05). Compared to group F, cTnⅠ and IL-6 in groups S and R at T1, T2, T3, and T4 decreased significantly (P<0.05). Conclusions Compared to fentanil, sufentanil and remifentanil had comparative advantages on lessening myocardial injury and inhibiting effect of inflammatory for patients who are undergoing cardiac valve replacement. Key words: Fentanyl/PD; Sufentanil/PD; Heart valve prosthesis implantation; Troponin I/ME; Interleukin-6/ME