Comparison of serum cortisol level in open heart surgery--morphine versus sufentanil

In open-heart surgery, cardiopulmonary bypass (CPB) can cause a rise in the level of stress hormones such as cortisol. Reducing this hormonal response is beneficial in the recovery period. Anesthetic agents and methods used in such operations have different effects on this response. In the present study two agents (morphine and sufentanil) routinely used for the cardiac surgery in Nemazi Hospital were compared regarding their effect on the serum cortisol levels.

Thirty patients undergoing coronary artery bypass grafting (CABG) in Nemazi Hospital were selected and divided into two groups. Group 1 (16 patients received morphine in a dose of 1 mg/kg) and Group 2 (14 patients received sufentanil in a dose of 5 microg/kg). Serum cortisol levels were measured before induction of anesthesia, after tracheal intubation, after initiation of CPB and twelve hours after the termination of operation.

Morphine and sufentanil both lowered the serum cortisol level during the operation. However, twelve hours after the operation, cortisol levels in both groups were higher than those taken in the previous set times.

Neither morphine nor sufentanil in the mentioned doses could reduce the endocrine response in the postoperative period, and thus have no preference, in cardiac surgery.