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Methylprednisolone Does Not Reduce Persistent Pain after Cardiac Surgery
- Source :
- Anesthesiology. 123:1404-1410
- Publication Year :
- 2015
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2015.
-
Abstract
- Background Persistent incisional pain is common after cardiac surgery and is believed to be in part related to inflammation and poorly controlled acute pain. Methylprednisolone is a corticosteroid with substantial antiinflammatory and analgesic properties and is thus likely to ameliorate persistent surgical pain. Therefore, the authors tested the primary hypothesis that patients randomized to methylprednisolone have less persistent incisional pain than those given placebo. Methods One thousand forty-three patients having cardiopulmonary bypass for cardiac surgery via a median sternotomy were included in this substudy of Steroids in Cardiac Surgery (SIRS) trial. Patients were randomized to 500 mg intraoperative methylprednisolone or placebo. Incisional pain was assessed at 30 days and 6 months after surgery, and the potential risk factors were also evaluated. Results Methylprednisolone administration did not reduce pain at 30 days or persistent incisional pain at 6 months, which occurred in 78 of 520 patients (15.7%) in the methylprednisolone group and in 88 of 523 patients (17.8%) in the placebo group. The odds ratio for methylprednisolone was 0.93 (95% CI, 0.79 to 1.09, P = 0.37). Furthermore, there was no difference in worst pain and average pain in the last 24 h, pain interference with daily life, or use of pain medicine at 6 months. Younger age, female sex, and surgical infections were associated with the development of persistent incisional pain. Conclusions Intraoperative methylprednisolone administration does not reduce persistent incisional pain at 6 months in patients recovering from cardiac surgery.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Pain medicine
Analgesic
Anti-Inflammatory Agents
Placebo
Methylprednisolone
law.invention
Sex Factors
Randomized controlled trial
Risk Factors
law
medicine
Humans
Cardiac Surgical Procedures
Aged
Pain, Postoperative
Cardiopulmonary Bypass
business.industry
Age Factors
Chronic pain
medicine.disease
Surgery
Cardiac surgery
Treatment Outcome
Anesthesiology and Pain Medicine
Median sternotomy
Anesthesia
Female
business
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 00033022
- Volume :
- 123
- Database :
- OpenAIRE
- Journal :
- Anesthesiology
- Accession number :
- edsair.doi.dedup.....34576f9aaeee5e63e4df88f942f3643b