Multimodal Analgesia Strategies for Cardiac Surgery: A Literature Review
心脏外科
医学
模式治疗法
心理学
外科
作者
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
出处
期刊:Hearts [Multidisciplinary Digital Publishing Institute] 日期:2024-08-21卷期号:5 (3): 349-364被引量:2
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.