Consequences of coronary artery bypass grafting in smokers and addicts

The most common cardiac disease is coronary artery disease (CAD) in the world. Coronary artery bypass grafting (CABG) is implemented through two standard surgical techniques, namely off-pump beating-heart CABG (OPCABG) and on-pump CABG (ONCABG). The CABG results in various levels of morbidity, especially in smokers and addicts, who have a lower pain threshold. Regarding this, the aim of this study was to clarify several aspects of the consequences of CABG, especially in smokers and addicts.
This cross-sectional study was conducted on 125 CABG candidates referring to the Cardiac Department of Ghaem Hospital in Mashhad, Iran, within 2014-2015. The patients underwent either OPCAB or ONCABG. The recorded data included the type and dosage of intra- and post-operative opioids used for the induction and maintenance of anaesthesia, as well as the volume of packed red blood cells, fresh frozen plasma, and platelet. Data analysed using IBM SPSS 19.0 and p-value less than 0.05 considered statistically significant.
According to the results, the mean age of the patients were 59.4±9.8 years. Out of the 125 participants, 89 and 36 patients underwent ONCABG and OPCABG, 71.9% and 58.3% of whom were male, respectively. The sufentanil dose administered for the induction of anaesthesia was 9.9±2.7 cc in the smokers, which was significantly higher in comparison to the dose (7.3±2.1 cc) used for the non-smokers (P=0.015). Furthermore, the mean doses of dobutamine used for the addicted and non-addiced patients were 4.4±1.8 and 5.5±2.2 cc, respectively, which was significantly different between the two groups (P=0.037).
The ONCABG is a common surgical technique, which is used in patients with a more coronary vessel involvement. This study has demonstrated that although the same opioid anaesthetic drugs were used for the smokers and addicted patient, the dose of administered sufentanil was significant different between smokers and non-smokers.