. 2014 Nov 24;172(8):2010–2025. doi: 10.1111/bph.12902

Table 3.

Effects of opioids on infarct size in patients

Study	Clinical scenario	Method to assess endpoint	Drug and dosage	Opioid [n]	Alternative anaesthesia or placebo [n]	Infarct size [Δ% of placebo]
Rentoukas et al., 2010	STEMI AMI	Troponin I (max during hospitalization)	Morphine, i.v. (5 mg) + RIPC vs. RIPC, no further medication	33	33	↓38
Abdel-Wahab et al., 2008 PROFIT	Elective PCI	Troponin T (max within 12 h)	Fentanyl (0.05 mg) vs. diazepam, both i.v.	94	90	↓31
		CK-MB (max within 12 h)	Fentanyl (0.05 mg) vs. diazepam, both i.v.	94		↓5
		Troponin T (max within 12 h)	Fentanyl (0.1 mg) vs. diazepam, both i.v.	92		↓8
		CK-MB (max within 12 h)	Fentanyl (0.1 mg) vs. diazepam, both i.v.	92		↑5
Slogoff et al., 1989	CABG	CK-MB (mean within 16 h)	Sufentanil (15–25 μg·kg⁻¹ and 5 mg·kg⁻¹) vs. enflurane or halothane or isoflurane on top of diazepam, pancuronium, fentanyl, all i.v.	254	257/253/248	–
Tuman et al., 1989	CABG	CK-MB (max within 72 h)	Fentanyl (>50 μg·kg⁻¹) vs. diazepam (0.4–1 mg·kg⁻¹) or halothane (0.5–2.5%) on top of benzodiazepine, scopolamine, isoflurane, enflurane, halothane all i.v. – except halothane volatile	240	250	↑67
						vs. diazepam
						↑3
						vs. halothane
			Fentanyl (<50 μg·kg⁻¹) vs. diazepam (0.4–1 mg·kg⁻¹) or halothane (0.5–2.5%) on top of benzodiazepine, scopolamine, isoflurane, enflurane, halothane all i.v. – except halothane volatile	345		↑57
						vs. diazepam
						↑9
						vs. halothane
			Sufentanil (3–8 μg·kg⁻¹) vs. diazepam (0.4–1 mg·kg⁻¹) or halothane (0.5–2.5%) on top of benzodiazepine, scopolamine, isoflurane, enflurane, halothane all i.v. – except halothane volatile	212		↑53
						vs. diazepam
						–
						vs. halothane
Neuhäuser et al., 2008	CABG	Troponin T (max within 24 h)	Sufentanil (0.25–1 μg·kg⁻¹) on top of flunitrazepam, morphine, midazolam, pancuronium vs. ketamine (1–3 mg·kg⁻¹) on top of flunitrazepam, morphine, midazolam, propofol, pancuronium all i.v.	108	101	↑50^*
Wong et al., 2010a	CABG	Troponin I (max within 24 h)	Remifentanil (1 and 0.5 μg·kg⁻¹) vs. placebo on top of morphine, scopolamine, entomidate, fentanyl, pancuronium, propofol all i.v.	20	20	↓38^*
Wong et al., 2010a	CABG	CK-MB (max within 24 h)		20	20	↓39^*

P < 0.05 versus alternative anaesthesia/placebo.

AMI, acute myocardial infarction; CABG, coronary artery bypass surgery; CK-MB, creatine kinase – muscle, brain; isch, ischaemia; max, maximum; PCI, percutaneous coronary intervention; rep, reperfusion; RIPC, remote ischaemic preconditioning; STEMI AMI, ST elevation myocardial infarction, acute myocardial infarction.