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Article: Remifentanil reduces the release of biochemical markers of myocardial damage after coronary artery bypass surgery: A randomized trial
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TitleRemifentanil reduces the release of biochemical markers of myocardial damage after coronary artery bypass surgery: A randomized trial
 
AuthorsWong, GTC1
Huang, Z2
Ji, S2
Irwin, MG1
 
Keywordsanesthetic preconditioning
cardiac surgery
myocardial protection
opioid
remifentanil
 
Issue Date2010
 
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jvca
 
CitationJournal Of Cardiothoracic And Vascular Anesthesia, 2010, v. 24 n. 5, p. 790-796 [How to Cite?]
DOI: http://dx.doi.org/10.1053/j.jvca.2009.09.012
 
AbstractObjective: Opioids, including remifentanil, have been demonstrated to confer cardiac protection against ischemia reperfusion injury in animals. This study evaluated whether remifentanil preconditioning is protective in first-time elective on-pump coronary artery bypass surgery patients receiving a standardized fentanyl (25 μg/kg in total) and propofol anesthetic. Design: A prospective, double blind, randomized, controlled study. Setting: University hospital; single institution. Participants: Forty patients scheduled for first-time elective, on-pump coronary artery bypass surgery for at least 3 diseased vessels. Interventions: Patients randomized to the remifentanil group (n = 20) received a 1 μg/kg bolus followed by a 0.5 μg/kg/min infusion for 30 minutes after induction but before sternotomy, while the control group (n = 20) received normal saline. Serial samples for measurement of creatine kinase (CK-MB), cardiac troponin I (cTnI), ischemia-modified albumin (IMA) and heart-type fatty-acid-binding protein (hFABP) were taken at baseline, prebypass, T = 10 minutes, 2, 6, 12, and 24 hours after cross-clamp release, to assess the degree of myocardial damage. Measurements and Main Results: Patients in the remifentanil group had lower levels of CK-MB from T = 2 hours to 24 hours, cTnI from T = 10 minutes to T = 12 hours, IMA from T = 10 minutes to T = 2 hours and h-FABP from T = 10 minutes to T = 12 hours (p < 0.05). The time to tracheal extubation was shorter in patients in the remifentanil group. The overall lengths of ICU and hospital stays were not different. Conclusions: The addition of remifentanil to the anesthesia regimen reduced the degree of myocardial damage. This incremental benefit may be attributable either to remifentanil itself or to an overall increased opioid dose, the latter may be necessary to trigger cardiac protection. © 2010 Elsevier Inc. All rights reserved.
 
ISSN1053-0770
2013 Impact Factor: 1.482
 
DOIhttp://dx.doi.org/10.1053/j.jvca.2009.09.012
 
ISI Accession Number IDWOS:000282669200010
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorWong, GTC
 
dc.contributor.authorHuang, Z
 
dc.contributor.authorJi, S
 
dc.contributor.authorIrwin, MG
 
dc.date.accessioned2010-12-23T08:32:16Z
 
dc.date.available2010-12-23T08:32:16Z
 
dc.date.issued2010
 
dc.description.abstractObjective: Opioids, including remifentanil, have been demonstrated to confer cardiac protection against ischemia reperfusion injury in animals. This study evaluated whether remifentanil preconditioning is protective in first-time elective on-pump coronary artery bypass surgery patients receiving a standardized fentanyl (25 μg/kg in total) and propofol anesthetic. Design: A prospective, double blind, randomized, controlled study. Setting: University hospital; single institution. Participants: Forty patients scheduled for first-time elective, on-pump coronary artery bypass surgery for at least 3 diseased vessels. Interventions: Patients randomized to the remifentanil group (n = 20) received a 1 μg/kg bolus followed by a 0.5 μg/kg/min infusion for 30 minutes after induction but before sternotomy, while the control group (n = 20) received normal saline. Serial samples for measurement of creatine kinase (CK-MB), cardiac troponin I (cTnI), ischemia-modified albumin (IMA) and heart-type fatty-acid-binding protein (hFABP) were taken at baseline, prebypass, T = 10 minutes, 2, 6, 12, and 24 hours after cross-clamp release, to assess the degree of myocardial damage. Measurements and Main Results: Patients in the remifentanil group had lower levels of CK-MB from T = 2 hours to 24 hours, cTnI from T = 10 minutes to T = 12 hours, IMA from T = 10 minutes to T = 2 hours and h-FABP from T = 10 minutes to T = 12 hours (p < 0.05). The time to tracheal extubation was shorter in patients in the remifentanil group. The overall lengths of ICU and hospital stays were not different. Conclusions: The addition of remifentanil to the anesthesia regimen reduced the degree of myocardial damage. This incremental benefit may be attributable either to remifentanil itself or to an overall increased opioid dose, the latter may be necessary to trigger cardiac protection. © 2010 Elsevier Inc. All rights reserved.
 
dc.description.naturepostprint
 
dc.identifier.citationJournal Of Cardiothoracic And Vascular Anesthesia, 2010, v. 24 n. 5, p. 790-796 [How to Cite?]
DOI: http://dx.doi.org/10.1053/j.jvca.2009.09.012
 
dc.identifier.doihttp://dx.doi.org/10.1053/j.jvca.2009.09.012
 
dc.identifier.eissn1532-8422
 
dc.identifier.epage796
 
dc.identifier.hkuros177956
 
dc.identifier.hkuros184520
 
dc.identifier.isiWOS:000282669200010
 
dc.identifier.issn1053-0770
2013 Impact Factor: 1.482
 
dc.identifier.issue5
 
dc.identifier.openurl
 
dc.identifier.pmid20056436
 
dc.identifier.scopuseid_2-s2.0-77957693411
 
dc.identifier.spage790
 
dc.identifier.urihttp://hdl.handle.net/10722/129087
 
dc.identifier.volume24
 
dc.languageeng
 
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jvca
 
dc.publisher.placeUnited States
 
dc.relation.ispartofJournal of Cardiothoracic and Vascular Anesthesia
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in Journal of Cardiothoracic and Vascular Anesthesia. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Cardiothoracic and Vascular Anesthesia, 2010, v. 24 n. 5, p. 790-796. DOI: 10.1053/j.jvca.2009.09.012
 
dc.subjectanesthetic preconditioning
 
dc.subjectcardiac surgery
 
dc.subjectmyocardial protection
 
dc.subjectopioid
 
dc.subjectremifentanil
 
dc.titleRemifentanil reduces the release of biochemical markers of myocardial damage after coronary artery bypass surgery: A randomized trial
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Sun Yat-sen Cardiovascular Hospital