Effect of the Aortic Root Infusion of Sufentanil on Ischemia-Reperfusion Injury in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Background: ischemic postconditioning is a novel strategy for attaining cardioprotection. remarkable evidence from various in vitro and in vivo animal and human studies have shown significant opioid-induced cardioprotection against myocardial ischemia/ reperfusion (i/r) injury. the purpose of this study was to assess the cardioprotective effect of sufentanil against i/r injury after on-pump coronary artery bypass grafting (cabg). methods: between june 2016 and july 2017, 80 consecutive patients with triple-vessel disease undergoing on-pump cabg were enrolled in this prospective randomized study. the patients assigned to the sufentanil group received a single dose of sufentanil (0.2 μg/kg diluted with 50 cc of saline) 5 minutes before the removal of the aorta cross-clamp, with the sufentanil injected via a cardioplegia needle into the aortic root. in the control group, the same volume of normal saline was injected as a placebo. cardiac enzymes, the inotrope score, and the outcome data were compared between the 2 groups. results: the mean age of the patients was 60.48±7.50 years (range=41–69 y), and men comprised 65.0% of the study population. the levels of ck-mb and cardiac troponin i were significantly lower in the sufentanil group (p<0.001). the amount of inotrope use (p<0.001), the incidence of atrial fibrillation (p=0.014), electrical shock (p=0.007), and the mechanical ventilation time (p<0.001) decreased in the sufentanil group compared with the control group. however, the use of intra-aortic balloon pumps (p=0.247) and the icu length of stay (p=0.867) were not significantly different between the 2 groups. conclusion: the injection of a single dose of sufentanil into the aortic root prior to aorta cross-clamp removal diminished cardiac injury during on-pump cabg in our patients.