Reducing Opioid Use in Cardiac Surgery with Multimodal Analgesia
Author Information
Author(s): Darras Marc MD, Schneider Clément MD, Marguerite Sandrine MD, Saadé Saadé MD, Maechel Anne-Lise MD, Oulehri Walid MD, Collange Olivier MD, PhD, Mazzucotelli Jean-Philippe MD, PhD, Mertes Paul-Michel MD, PhD, Kindo Michel MD, PhD
Primary Institution: Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
Hypothesis
Does a multimodal analgesia protocol with a parasternal plane block reduce opioid use in patients undergoing cardiac surgery?
Conclusion
The study found that implementing a multimodal analgesia protocol significantly reduces opioid consumption and increases the rate of opioid-free patients after cardiac surgery.
Supporting Evidence
- The opioid-free rate in the ICU was 94.0% in the ERAS group compared to 19.9% in the control group.
- Opioid consumption in the ICU was significantly lower in the ERAS group (11.0 MME) compared to the control group (31.0 MME).
- Secondary outcomes showed reduced mechanical ventilation duration and lower rates of postoperative complications in the ERAS group.
Takeaway
This study shows that using a special pain management plan can help many heart surgery patients avoid using opioids, which can be harmful.
Methodology
The study analyzed data from 3153 patients who underwent cardiac surgery, comparing those who received an enhanced recovery program with those who did not, using propensity score matching.
Potential Biases
Potential biases may arise from the non-randomized design and the lack of comprehensive documentation of opioid-related adverse events.
Limitations
The study is limited to a single center, and the specific type of parasternal plane block used was not recorded.
Participant Demographics
Patients included were opioid-naïve individuals undergoing elective coronary artery bypass grafting and/or valve procedures.
Statistical Information
P-Value
<0.001
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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