Yue Yue MBBS , Hongyan Ji MBBS , Shizhong Wang PhD , Huawei Cheng MBBS , Rongmei Wang MSc , Haijun Qu MSc , Jing Li MSc
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Multiple clinical measures have been taken to avoid overuse of opioid agents for postoperative pain management, which led to the development of clinical pathways for analgesic drug treatment using a multimodal approach.</p></div><div><h3>Objective</h3><p>To evaluate the effectiveness and safety of a multimodal postoperative analgesic drug pathway (ADP) for pain management following cardiovascular surgery.</p></div><div><h3>Methods</h3><p>This retrospective, controlled, nonrandomized study evaluated a postoperative ADP in patients undergoing cardiovascular surgery in a tertiary general hospital in Qingdao, China. Effectiveness and safety outcomes were compared before and after the implementation of the ADP. Outcome indicators included postoperative pain scores, consumption of opioids in analgesic pumps, and incidence of adverse events.</p></div><div><h3>Results</h3><p>Patients who underwent cardiovascular surgery from September to November 2021 before the implementation of the ADP (n = 193) and from September to November 2022 after the implementation of the ADP (n = 218) were enrolled. Pain scores were reduced on day 1, 3, and 5 after surgery and the reduction was most significant in mild pain (<em>P</em> < .001). Opioids in analgesic pumps consumption was also significantly reduced and there was decreased incidence of adverse events such as nausea and vomiting (<em>P</em> = .026), respiratory inhibition (<em>P</em> = .027), and dizziness and headache (<em>P</em> = .028) in cardiovascular surgery patients after implementation of the ADP.</p></div><div><h3>Conclusions</h3><p>Improved effectiveness and safety were observed following the implementation of the ADP. Multimodal analgesic ADP methodology can be effectively used for postoperative pain management in patients undergoing cardiovascular surgery.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0011393X24000146/pdfft?md5=eafbb289bca97d2baca3da608d5ff777&pid=1-s2.0-S0011393X24000146-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Evaluation of Analgesic Drug Therapy for Postoperative Pain Management in Cardiovascular Surgery\",\"authors\":\"Yue Yue MBBS , Hongyan Ji MBBS , Shizhong Wang PhD , Huawei Cheng MBBS , Rongmei Wang MSc , Haijun Qu MSc , Jing Li MSc\",\"doi\":\"10.1016/j.curtheres.2024.100744\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Cardiovascular surgery is usually associated with higher degree of postoperative pain that influences a patient's physical recovery. Multiple clinical measures have been taken to avoid overuse of opioid agents for postoperative pain management, which led to the development of clinical pathways for analgesic drug treatment using a multimodal approach.</p></div><div><h3>Objective</h3><p>To evaluate the effectiveness and safety of a multimodal postoperative analgesic drug pathway (ADP) for pain management following cardiovascular surgery.</p></div><div><h3>Methods</h3><p>This retrospective, controlled, nonrandomized study evaluated a postoperative ADP in patients undergoing cardiovascular surgery in a tertiary general hospital in Qingdao, China. Effectiveness and safety outcomes were compared before and after the implementation of the ADP. Outcome indicators included postoperative pain scores, consumption of opioids in analgesic pumps, and incidence of adverse events.</p></div><div><h3>Results</h3><p>Patients who underwent cardiovascular surgery from September to November 2021 before the implementation of the ADP (n = 193) and from September to November 2022 after the implementation of the ADP (n = 218) were enrolled. Pain scores were reduced on day 1, 3, and 5 after surgery and the reduction was most significant in mild pain (<em>P</em> < .001). Opioids in analgesic pumps consumption was also significantly reduced and there was decreased incidence of adverse events such as nausea and vomiting (<em>P</em> = .026), respiratory inhibition (<em>P</em> = .027), and dizziness and headache (<em>P</em> = .028) in cardiovascular surgery patients after implementation of the ADP.</p></div><div><h3>Conclusions</h3><p>Improved effectiveness and safety were observed following the implementation of the ADP. Multimodal analgesic ADP methodology can be effectively used for postoperative pain management in patients undergoing cardiovascular surgery.</p></div>\",\"PeriodicalId\":10920,\"journal\":{\"name\":\"Current Therapeutic Research-clinical and Experimental\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0011393X24000146/pdfft?md5=eafbb289bca97d2baca3da608d5ff777&pid=1-s2.0-S0011393X24000146-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Therapeutic Research-clinical and Experimental\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0011393X24000146\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Therapeutic Research-clinical and Experimental","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0011393X24000146","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
背景心血管手术通常伴有较高程度的术后疼痛,影响患者的身体恢复。为避免过度使用阿片类药物进行术后疼痛治疗,临床上采取了多种措施,并由此开发了使用多模式镇痛药物治疗的临床路径。 Objective To evaluate the effectiveness and safety of a multimodal postoperative analgesic drug pathway (ADP) for pain management following cardiovascular surgery.Methods这项回顾性、对照、非随机研究评估了中国青岛一家三级综合医院心血管手术患者术后使用多模式镇痛药物治疗的有效性和安全性。研究比较了 ADP 实施前后的有效性和安全性。结果2021年9月至11月ADP实施前(n = 193)和2022年9月至11月ADP实施后(n = 218)接受心血管手术的患者均被纳入研究。术后第1天、第3天和第5天的疼痛评分均有所降低,轻度疼痛的评分降低最为显著(P < .001)。实施 ADP 后,心血管手术患者的阿片类镇痛泵用量也明显减少,恶心呕吐(P = .026)、呼吸抑制(P = .027)、头晕头痛(P = .028)等不良反应的发生率也有所下降。多模式镇痛 ADP 方法可有效用于心血管手术患者的术后疼痛治疗。
Evaluation of Analgesic Drug Therapy for Postoperative Pain Management in Cardiovascular Surgery
Background
Cardiovascular surgery is usually associated with higher degree of postoperative pain that influences a patient's physical recovery. Multiple clinical measures have been taken to avoid overuse of opioid agents for postoperative pain management, which led to the development of clinical pathways for analgesic drug treatment using a multimodal approach.
Objective
To evaluate the effectiveness and safety of a multimodal postoperative analgesic drug pathway (ADP) for pain management following cardiovascular surgery.
Methods
This retrospective, controlled, nonrandomized study evaluated a postoperative ADP in patients undergoing cardiovascular surgery in a tertiary general hospital in Qingdao, China. Effectiveness and safety outcomes were compared before and after the implementation of the ADP. Outcome indicators included postoperative pain scores, consumption of opioids in analgesic pumps, and incidence of adverse events.
Results
Patients who underwent cardiovascular surgery from September to November 2021 before the implementation of the ADP (n = 193) and from September to November 2022 after the implementation of the ADP (n = 218) were enrolled. Pain scores were reduced on day 1, 3, and 5 after surgery and the reduction was most significant in mild pain (P < .001). Opioids in analgesic pumps consumption was also significantly reduced and there was decreased incidence of adverse events such as nausea and vomiting (P = .026), respiratory inhibition (P = .027), and dizziness and headache (P = .028) in cardiovascular surgery patients after implementation of the ADP.
Conclusions
Improved effectiveness and safety were observed following the implementation of the ADP. Multimodal analgesic ADP methodology can be effectively used for postoperative pain management in patients undergoing cardiovascular surgery.
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