Intrathecal sufentanil for coronary artery bypass grafting

Caetano Nigro Neto, Jose L uiz Gomes do Amaral, Renato Arnoni, Maria A ngela Tardelli, Giovanni Landoni

Research output: Contribution to journalArticlepeer-review

Abstract

CONTEXT: Cardiac surgery patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.

OBJECTIVE: Evaluate the effect of adding intrathecal sufentanil to general anesthesia on hemodynamics.

DESIGN: Prospective, randomized, not blinded study, after approval by local ethics in Research Committee.

SETTING: Monocentric study performed at Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil.

PATIENTS: 40 consenting patients undergoing elective coronary artery bypass, both genders.

EXCLUSION CRITERIA: Chronic kidney disease; emergency procedures; reoperations; contraindication to spinal block; left ventricular ejection fraction less than 40%; body mass index above 32kg/m(2) and use of nitroglycerin.

INTERVENTIONS: Patients were randomly assigned to receive intrathecal sufentanil 1μg/kg or not. Anesthesia induced and maintained with sevoflurane and continuous infusion of remifentanil.

MAIN OUTCOME MEASURES: Hemodynamic variables, blood levels of cardiac troponin I, B-type natriuretic peptide, interleukin-6 and tumor necrosis factor alfa during and after surgery.

RESULTS: Patients in sufentanil group required less inotropic support with dopamine when compared to control group (9.5% vs 58%, p=0.001) and less increases in remifentanil doses (62% vs 100%, p=0.004). Hemodynamic data at eight different time points and biochemical data showed no differences between groups.

CONCLUSIONS: Patients receiving intrathecal sufentanil have more hemodynamical stability, as suggested by the reduced inotropic support and fewer adjustments in intravenous opioid doses.

Original languageEnglish
Pages (from-to)73-78
Number of pages6
JournalBrazilian journal of anesthesiology (Elsevier)
Volume64
Issue number2
DOIs
Publication statusPublished - Mar 1 2014

Keywords

  • Cardiac surgery
  • Interleukin 6
  • Spinal anesthesia
  • Sufentanil

ASJC Scopus subject areas

  • Medicine(all)

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