1. Multimodal analgesia with parasternal plane block protocol within an enhanced recovery after cardiac surgery program decreases opioid useCentral MessagePerspective
- Author
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Marc Darras, MD, Clément Schneider, MD, Sandrine Marguerite, MD, Saadé Saadé, MD, Anne-Lise Maechel, MD, Walid Oulehri, MD, Olivier Collange, MD, PhD, Jean-Philippe Mazzucotelli, MD, PhD, Paul-Michel Mertes, MD, PhD, and Michel Kindo, MD, PhD
- Subjects
cardiac surgery ,multimodal analgesia ,opioid ,regional plane block ,enhanced recovery after cardiac surgery ,perioperative ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Surgery ,RD1-811 - Abstract
Objective: This study investigated the efficacy of a multimodal analgesia (MMA) with an opioid-sparing strategy, incorporating a parasternal plane block (PPB) within a systematic standardized Enhanced Recovery After Surgery (ERAS) program for patients undergoing elective cardiac surgery. Methods: From 2015 to 2021, 3153 patients underwent elective coronary artery bypass grafting and/or valve procedures. Patients were dichotomized by the presence or absence of an ERAS program including a perioperative MMA with an opioid-sparing approach and PPB protocols. Propensity score matching yielded 1026 well-matched pairs. The primary outcomes were the opioid-free rate and the opioid consumption in morphine milligram equivalents (MME) in the intensive care unit (ICU). The secondary outcomes were postoperative visual analog scale (VAS) scores, mechanical ventilation duration, ileus, delirium, bronchopneumonia, and length of ICU stay. Results: The ICU opioid-free rate was significantly increased in the ERAS group (94.0%) compared with the control group (19.9%; P
- Published
- 2024
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