[Remifentanil preconditioning lowers cardiac troponin I levels in patients undergoing off-pump coronary artery bypass graft surgery].
OBJECTIVE
To investigate the value of cardiac troponin I (cTnI) levels in assessing myocardial protection by remifentanil precondition against myocardial injury induced by off-pump coronary artery bypass (OPCAB).


METHODS
Twenty-four patients undergoing OPCAB were randomized into control and remifentanil preconditioning group (n=12). All the patients received pretreatment with oral diazepam (10 mg), intramuscular morphine (10 mg) and hyosine (0.3 mg). General anesthesia was induced with midazolam (0.08 mg/kg), etomidate (0.1-0.3 mg/kg), fentanyl (5-10 microg/kg), and rocuronium (1 mg/kg), and maintained with isoflurane inhalation and propofol infusion. Intermittent fentanyl and pipecuronium were given intravenously. In remifentanil preconditioning group, remifentanil (5 microg/kg in 50 ml normal saline) was infused in 10 min after anesthesia induction, and only NS was administered in the control group. Blood samples were obtained before and at 0, 2, 6, 24, and 48 h after the operation to determine serum cTnI levels.


RESULTS
In both of the two groups, the cTnI levels increased significantly at the postoperative time points (0, 2, 6, 24, and 48 h) as compared with those before the operation (P<0.05). The cTnI levels of remifentanil preconditioning group were markedly decreased after the operation in comparison with those of the control group (P<0.05).


CONCLUSIONS
Remifentanil preconditioning decreases the cTnI levels and reduces myocardial injury induced by OPCAB.
Xu
Zhong-dong
ZD
Department of Anesthesiology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China. xuzhongdong88 @163.com
Jin
Mu
M
He
Wei-xiong
WX
Xia
Shu-xuan
SX
Zhao
Yi-fan
YF
He
Bo
B
Cao
De-xiong
DX
Peng
Shu-ling
SL
Li
Jue
J
Cao
Ming-hui
MH
D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000209:etiology / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism*; D010880:Piperidines / Q000494:pharmacology*; D011184:Postoperative Period; D000077208:Remifentanil; D013997:Time Factors; D019210:Troponin I / Q000097:blood / Q000378:metabolism*
D010880:Piperidines; D019210:Troponin I; D000077208:Remifentanil