Analysis of early cardiac complications after coronary artery bypass grafting under two different regimens of anesthesia

S.R. Maruniak ^{1, 2}, O.A. Loskutov ^{1, 2}, I.R. Malysh ¹

¹Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
²Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine

The aim – to analyze the effect of two different schemes of anesthesia on early cardiac complications in patients with coronary artery bypass grafting (CABG) with cardiopulmonary bypass.
Materials and methods. The study included 120 patients who underwent CABG with cardiopulmonary bypass (CPB). The median surgery risk according to EuroSCORE II was 3.45 % (2.15 %; 4.05 %). According to the scheme of anesthesia, all patients were divided into two groups: the first group (60 patients) – low-opioid scheme of anesthesia; the second group (60 patients) – a standard scheme of anesthesia.
Results. Patients in the first group were more than twice as likely to develop postoperative atrial fibrillation compared to the second group (9 (15.0 %) vs. 19 (31.7 %), p = 0.031). In addition, patients in the first group were 2.3 times significantly less likely to have low cardiac output syndrome (LCOS) compared to the second group (11.7 % vs. 26.7 %, p = 0.037). The duration of CPB (p = 0.032) and the level of interleukin-6 after CPB (p = 0.004) were reliable indicators for predicting LCOS. The final statistical model [F (4, N = 120) = 12.52, p < 0.001, R2 = 0.304] covers almost a third of all factors in the development of LCOS. Only the level of interleukin-6 after CPB (the final statistical model
(F (4, N = 120) = 11.54, p < 0.001, R2 = 0.286) was a reliable indicator for predicting postoperative atrial fibrillation.
Conclusions. The obtained results confirm the safety of clinical use of anesthesia schemes with low doses of opioids in cardiac surgery patients and emphasize the possibility of a more conservative use of opioids in cardiac surgery.

Key words: coronary artery bypass grafting, low-opioid anesthesia, low cardiac output syndrome, postoperative atrial fibrillation

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