Safety of Orexin Receptor Antagonist on Cardiac and Respiratory Function in Patients who Underwent Off-pump Coronary Artery Bypass Grafting

Abstract

Suvorexant is an orexin receptor antagonist for the treatment of insomnia, and many studies reported the effect 1,2) . Suvorexant improved sleep as assessed by the Insomnia Severity Index, and improved the impact of insomnia on daytime function/quality-of-life, too 1) . Additionally, the recent studies reported that Suvorexant had the effi cacy for the prevention of delirium during acute hospitalization [3][4][5] .There are a few reports about the respiratory effect of Suvorexant [6][7][8][9] . Though Shitara et al. 6) reported that Suvorexant could be used in heart failure patients without affecting their sleep-disordered breathing, there were few studies to investigate the respiratory effect of Suvorexant after cardiac surgery. Additionally, there were few reports to demonstrate whether Suvorexant af-fected the cardiac functions. So, this study aims to examine the effect on the respiratory and the cardiac function of Suvorexant in patients who underwent off-pump coronary artery bypass grafting (OPCAB). II. Materials and methodsThis retrospective study was approved by the Institutional Review Board of Soka Municipal Hospital, and written informed consent was obtained from all of the patients included in this study.A total of 187 consecutive patients undergoing elective coronary artery bypass grafting (CABG) at our hospital between February 2013 and June 2020. In our hospital, as a unit policy weaning from a respirator was not performed on the day of operation. We excluded patients who underwent an emergency operation, and those with a mental disorder, a sleep disorder and dementia. Though artificial heart-lung apparatus affects postoperative respiratory function, 66 patients who underwent OPCAB (16 women, mean age 71.6 ± 8.1 years) were included.Induction and maintenance of anesthesia were similar in all patients who received weight-related doses of fentanyl, midazolam, and pancuronium bromide.

Efficacy of Orexin Receptor Antagonist for Postoperative Atrial Fibrillation in Patients Who Underwent Off-Pump Coronary Artery Bypass Grafting

“…13,14) A few reports reported the postoperative effect of suvorexant in patients who underwent cardiovascular surgery. [15][16][17] However, a few studies reported suvorexant effects for POAF. So, this study aims to examine the effect of suvorexant for POAF in patients who underwent off-pump coronary artery bypass grafting (OPCAB).…”