Effects of remifentanil and fentanyl on the cell-mediated immune response in patients undergoing elective coronary artery bypass graft surgery.
J Int Med Res
; 36(6): 1235-47, 2008.
Article
em En
| MEDLINE
| ID: mdl-19094432
ABSTRACT
This prospective randomized pilot study compared the influence of fentanyl-based versus remifentanil-based anaesthesia on cytokine responses and expression of the suppressor of cytokine signalling (SOCS)-3 gene following coronary artery bypass graft surgery. Forty patients were assigned to receive anaesthesia with either intravenous remifentanil (0.3 - 0.6 microg/kg per min; n = 20) or intravenous fentanyl (5 - 10 microg/kg per h; n = 20). Levels of interleukin (IL)-6, IL-10, tumour necrosis factor-alpha and interferon-gamma (IFN-gamma) and the expression of SOCS-3 were measured pre- and post-operatively. The data from 33 of the patients were analysed. The IFN-gamma/IL-10 ratio after concanavalin A stimulation in whole blood cells on post-operative day 1 and SOCS-3 gene expression on post-operative day 2 were significantly lower in the remifentanil group than in the fentanyl group. The time in the intensive care unit was also significantly lower in the remifentanil group. These findings suggest that remifentanil can attenuate the exaggerated inflammatory response that occurs after cardiac surgery with cardiopulmonary bypass. Further clinical trials are required to define the influence of choice of intra-operative opioid on post-operative outcome.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Piperidinas
/
Fentanila
/
Ponte de Artéria Coronária
/
Citocinas
/
Anestésicos Intravenosos
/
Imunidade Celular
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
J Int Med Res
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Alemanha