The impact of perioperative sufentanil administration on cardiovascular outcomes in non-small cell lung cancer patients treated with immune checkpoint inhibitors

Background Non-small cell lung cancer(NSCLC) patients treated with immune checkpoint inhibitors(ICIs)are at an increased risk of cardiovascular adverse events during surgery. This study investigated the impact of perioperative sufentanil administration on reducing these risks. Methods From July 2021 to July 2022, this observational study included 139 NSCLC patients at our institution, split into an experimental group(n=88) receiving sufentanil during surgery and a control group(n=51) who did not. The study focused on evaluating major adverse cardiovascular events(MACEs), arrhythmias, elevated troponin I, and B-type natriuretic peptide(BNP) levels as primary endpoints. Results The experimental group experienced a lower incidence of arrhythmias at 9.1% compared to 19.6% in the control group(P=0.045), indicating a significant protective effect of sufentanil. No significant differences were found in MACEs rates(8.0% in the experimental group vs. 11.8% in the control group, P=0.710),elevated troponin I(12.5% vs. 19.6%, P=0.147), or BNP levels(26.1% vs. 31.4%, P=0.875). Patients with existing cardiovascular risk factors demonstrated a higher overall incidence of cardiovascular adverse events, underscoring the compounded risk that these factors posed. Conclusions Perioperative administration of sufentanil in NSCLC patients undergoing surgery post-ICI therapy shows a significant reduction in the incidence of arrhythmias, suggesting a protective cardiovascular effect. This finding highlighted the importance of sufentanil in managing the perioperative cardiovascular risk of these patients.[S Chin J Cardiol 2024;25(1):21-28]