The influence of opioid to troponin Ⅰ , and IL-6 in patients undergoing cardiac surgery
10.3760/cma.j.issn.1008-1372.2016.08.010
- VernacularTitle:阿片类药物对心脏手术患者cTnⅠ、IL-6的影响
- Author:
Yiwen TAN
;
Yi TIAN
;
Saijuan LIN
;
Yunbai HUANG
;
Renxian CAI
;
Chunyan HOU
- Publication Type:Journal Article
- Keywords:
Fentanyl/PD;
Sufentanil/PD;
Heart valve prosthesis implantation;
Troponin Ⅰ/ME;
Interleukin-6/ME
- From:
Journal of Chinese Physician
2016;18(8):1158-1161
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the change of cardiac troponin Ⅰ (cTn Ⅰ),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,cTn Ⅰ and IL-6 in three group at T1,T2,T3 were significantly higher (P < 0.05),cTn Ⅰ reached the peak level at T4 (P < 0.05),IL-6 reached the peak level at T3 (P < 0.05).Compared to group F,cTn Ⅰ and IL-6 in groups S and R at T1,T2,T3,and T4 decreased significantly (P <0.05).Conclusion 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.