High-dose versus low-dose sufentanil anesthesia for patients undergoing off-pump coronary artery bypass grafting: A retrospective study from single cardiovascular center

High-dose opioid anesthesia has been the mainstay of cardiac anesthesia for decades. Yet emerging evidence has shown that low-dose opioid anesthesia may be of equal safety and effectiveness in cardiac surgery. We compared the outcomes of 2 different sufentanil dosing regimens (<4 μg/kg vs > 4 μg/kg) in off-pump coronary artery bypass grafting (OPCAB) surgery. The study identified all patients undergoing elective OPCAB at a single large-volume cardiovascular center between January 2020 and December 2020. Based on total intraoperative sufentanil dosing, patients were divided into 2 groups: low-dose group (LD ≤ 4 μg/kg) and high-dose group (HD > 4 μg/kg). The primary outcome was postoperative mechanical ventilation duration (MVD). Secondary outcomes included the incidences of postoperative acute myocardial infarction, stroke, acute kidney injury, and pulmonary infection, as well as postoperative level of high-sensitivity cardiac troponin I, postoperative length of stay in the intensive care unit and hospital, and hospitalized mortality rate. Postoperative MVD in LD group was shorter than that in HD group (16.0 hours vs 16.8 hours, P = .002). There was no difference with respect to either the incidences of postoperative acute myocardial infarction, stroke, acute kidney injury, and pulmonary infection or postoperative high-sensitivity cardiac troponin I concentrations (P > .05). Similarly, no difference was observed in postoperative length of stay in the intensive care unit and hospital as well as hospitalized mortality rate (P > .05). The current study suggested that low-dose sufentanil shortened postoperative MVD without increased risk of other complications in patients undergoing OPCAB.