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Multimodal Analgesia Strategies for Cardiac Surgery: A Literature Review

Authors :
Rostand Moreira Fernandes
João Paulo Jordão Pontes
Celso Eduardo Rezende Borges
Demócrito Ribeiro de Brito Neto
Anastácio de Jesus Pereira
Vergílio Pereira Carvalho
Lucas Gonçalves Gomes
Fernando Cássio do Prado Silva
Source :
Hearts, Vol 5, Iss 3, Pp 349-364 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

In cardiac surgery, poststernotomy pain is a significant issue, peaking within 48 h and requiring proper analgesia for both acute relief and avoidance of chronicization. Opioids are commonly used for pain management postsurgery but pose risks such as adverse effects and dependency. Post-cardiac surgery pain can stem from various sources—somatic, visceral, and neuropathic—making opioid reliance a concern. Multimodal analgesia, which combines different medications and regional anesthesia techniques, is increasingly recommended to decrease opioid use and its related problems. Strategies include acetaminophen, gabapentinoids, NMDA antagonists, alpha-2 agonists, intravenous lidocaine, anti-inflammatory drugs, and regional anesthesia. These approaches can enhance pain control, reduce opioid reliance, and improve cardiac surgery outcomes. The ERAS® Cardiac Society strongly advocates for an opioid-sparing multimodal approach to improve patient recovery by reducing complications and increasing patient satisfaction. This review aims to consolidate current evidence to assist healthcare providers in customizing pain management for patients post-cardiac surgery, emphasizing reduced opioid use and optimizing the recovery process.

Details

Language :
English
ISSN :
26733846
Volume :
5
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Hearts
Publication Type :
Academic Journal
Accession number :
edsdoj.09dc44e740cb4b4ebab9340fdbcedb9a
Document Type :
article
Full Text :
https://doi.org/10.3390/hearts5030025