EFFECTS OF SUFENTANIL COMBINED WITH REMIFENTANIL ANALGESIA ON THE INFLAMMATORY RESPONSE, STRESS STATE AND NERVE-RELATED PEPTIDES

Ruiying Zhang, Qiaoyan Zhou, JiaweiChen, Baoyan Huang, Dan Wu, Yuguang Zhang^*

Department of Anesthesiology, Pujiang People’s hospital, Jinhua, 322200, China

Objective: ObjectiveThis study aimed to explore effects of sufentanil combined with remifentanil analgesia in elderly patients received cardiac surgery under general anesthesia and its influences on inflammatory response, oxidative stress and nerve-related peptides. 

Methods: A total of 147 patients undergoing cardiac surgery in our hospital were selected as objects of the research, of which 50 patients received sufentanil combined with remifentanil analgesia anesthesia during surgery as a joint group. Forty-eight patients received sufentanil analgesia during surgery as group A. Another 49 patients received remifentanil analgesia during surgery as group B. The recovery time of consciousness of patients wasrecorded. Before anesthesia (T0), 10 minutes(T1), 60 minutes (T2) and 180 minutes (T3) after arterial opening, the patients were scored with alertness/sedation (OAA/S), and venous blood was drawn.The levels of cTnl, SOD, MDA, NES, Aβ, S100β and inflammatory factors IL-6, IL-8 and TNF-α of patients were detected in the three groups.

Results: The recovery time of consciousness in group A was the highest among the three groups (P<0.001), while that injoint group was significantly lower than that in group A and higher than that in group B (P<0.001). The OAA/S scores of the three groups decreased gradually, peaked at T2 and then began to rise (P<0.001). The cTnl increased and the peak value began to decrease at T2 (P<0.001). SOD decreased and MDA increased (P<0.001). There was no significant difference in IL-6 and IL-8 between group A and group B (P>0.050), and TNF-a was significantly lower than that in group B (P<0.001). S100β was higher than that in group B (P<0.001). The levels of TNF-a, IL-6, IL-8, NES, S100β and Aβ in the joint group were significantly lower than those in the other two groups (P<0.001).

Conclusion: Remifentanil combined with sufentanil analgesia in elderly cardiac surgery can effectively reduce inflammatory response, nerve injury and oxidative stress response of patients, which has high safety and is worthy of clinical application.