ABSTRACT
CHRISTINE SISK. Effectiveness of Cardiac ERAS Multimodal Analgesia on Perioperative Pain in Adult Cardiac Surgery Patients. (Under the direction of Dr. KATHLEEN JORDAN)
Cardiac surgeries often rely on opioid analgesics, which can lead to adverse effects. The implementation of the multimodal analgesic approach, as a part of the ERAS protocol, has the potential to optimize intra- and postoperative pain management, leading to reduced opioid-related complications and improved patient outcomes. The purpose of this study was to evaluate the efficacy of multimodal analgesia within a Cardiac Enhanced Recovery After Surgery (ERAS) program in reducing postoperative pain and opioid consumption in adult cardiac surgery patients. This study compared the effects of cardiac ERAS multimodal analgesia against traditional opioid-based analgesia on postoperative pain and opioid consumption during the operation and the initial 24 hours postoperative.
The study was conducted at a level-one trauma center that had recently implemented the ERAS protocol on all cardiac surgical patients. Data was collected retrospectively from patients undergoing cardiac surgeries before and after the protocol’s implementation. The pre-ERAS group received traditional opioid-based analgesia, while the ERAS group received the ERAS multimodal analgesia protocol.
Data analysis revealed significantly lower intraoperative opioid consumption in the post-ERAS group compared to the pre-ERAS group (U = 1496.00, p = .026, z = -2.30). However, no statistically significant differences were observed in opioid consumption between the groups at 6 hours and 24 hours postoperatively. These findings suggest the ERAS protocol’s effectiveness in reducing intraoperative opioid requirements but limited impact on postoperative opioid consumption within the first 24 hours.
The study demonstrates that cardiac ERAS multimodal analgesia can effectively reduce intraoperative opioid consumption, highlighting its potential as a valuable component of perioperative pain management in cardiac surgery. While the findings did not show a significant reduction in postoperative opioid use, implementing such protocols can still offer benefits for patient care. This includes reducing opioid-related adverse effects and potentially improving patients’ overall recovery. Further research is needed to explore the longer-term impacts of multimodal analgesia on postoperative opioid consumption and patient outcomes in cardiac surgery.