The effect of intrathecal sufentanil preconditioning against myocardial ischemia-reperfusion injury.

OBJECTIVES: We aimed to investigate the cardioprotective effect and hemodynamic response of intrathecally administered sufentanil on myocardial IR injury. BACKGROUND: Sufentanil, mu opioid receptor agonist, intravenously administered during clinical and experimental studies, has been shown to have a cardioprotective effect on myocardial ischemia-reperfusion injury. METHODS: Thirty-two New Zealand type rabbits, which were anesthetized, were divided into four equal groups: sham, ischemia-reperfusion, sufentanil and ischemia-reperfusion+sufentanil. Sufentanil was administered intrathecally prior to ischemia. Hemodynamic parameters were monitored by electrocardiography and invasive arterial blood pressure measurements. In the ischemia-reperfusion groups, the degree of myocardial infarct was determined as the ratio of ischemic region to the risk area by a 1 % 2,3,5-triphenyl tetrazolium chloride staining. RESULTS: The mean infarct size in the ischemia-reperfusion group was 47.5 ± 7.0 %, whereas that of the ischemia-reperfusion+sufentanil group was found to be 34.2 ± 4.7 %, indicating a statistically significant difference (p = 0.002). The heart rate was different between the ischemia-reperfusion and the sufentanil groups for baseline measurement and between the ischemia-reperfusion and the ischemia-reperfusion+sufentanil groups at the 120th minutes measurement (p < 0.05). CONCLUSION: Intrathecal sufentanil appears to have a cardioprotective effect against myocardial ischemia--reperfusion injury in the experimental rabbit model (Tab. 1, Fig. 2, Ref. 19).

Primary cardiac myxomas: report of 28 cases and review the literature.

PURPOSE: Although primary cardiac tumors are rare, cardiac myxoma is the most common seen intracardiac tumor. This study summarizes our surgical experience with cardiac myxomas. METHODS: Twenty-eight cases of cardiac myxoma that were surgically treated in our center between January 1990 and March 2010 were retrospectively reviewed. In all patients the New York Heart Association (NYHA) functional classification was used to assess the functional status, and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were measured before and after surgery. RESULTS: Nineteen patients were female and 9 male. The mean age was 53.3 ± 12.7 years (range 4-73). The most common symptom was dyspnea (86%). Two patients presented with peripheral embolism. In preoperative assessment of functional status, 24 of the patients were in NYHA Class II, 2 of them were in Class I and the other 2 patients were in Class III. All patients were in NYHA class I in the early postoperative period up to long-term follow up. The mean preoperative CRP and ESR levels were 47.3 ± 14.6 mg/l (range 30-79) and 52.8 ± 21.4 mm/h (range 28-82), respectively. One month after surgery, CRP and ESR levels returned back to normal values. Postoperative CRP and ESR levels were 8.4 ± 2.6 mg/l (range 1-12) and 7.9 ± 4.8 mm/h (range 3-18), respectively. CONCLUSION: Myxomas should be considered in all patients with embolism. After surgical resection of cardiac myxomas, the functional status of patients improve and CRP and ESR levels become normal.