Cardiothoracic & vascular anesthesia
Comparative Efficacy of Adjuvant Nonopioid Analgesia in Adult Cardiac Surgical Patients: A Network Meta-Analysis
Authors' conclusion
Given the increasing emphasis on enhanced recovery after surgery(ERAS) protocols and the eventual goal of limiting opiate prescriptions postoperatively, the authors' data suggested far greater use of nonopioid adjuncts to minimize pain and enhance recovery following cardiac surgery.
Study context
- Population
- Adults (≥18 years) undergoing cardiac surgery124 RCTs, 110 analysed
- Participants
- 26,257 adults
- Comparison
- Adjuvant nonopioid analgesic regimens vs standard care and/or placebo
- Acetaminophenn = 176
- Magnesiumn = 323
- Gabapentinn = 96
- Clonidinen = 64
- Outcome
- Resting postoperative pain scores
- Follow-up
- 24 hours
Methodological detailsfrequentist, random-effects, PRISMA-NMA, risk of bias (RoB) 2, Confidence in Network Meta-Analysis, Databases searched from inception to October 9, 2021
- Frequentist
- Random-effects
- PRISMA-NMA
- RoB 2
- Confidence in Network Meta-Analysis
- Databases searched from inception to October 9, 2021
Pooled result
As reported in the abstract
Resting postoperative pain score
Each group vs standard care and/or placeboMD, points (95% CI)
Acetaminophenhigh confidence
−0.66(−1.16 to −0.15)
Gabapentinmoderate confidence
−0.40(−0.71 to −0.09)
- Magnesium · high confidence
- −0.05 points (95% CI −0.07 to −0.02)
- Clonidine · moderate confidence
- MD v0.38 points (95% CI −0.73 to v0.04)
Further pooled results
24-hour opioid consumption
- Significantly reduced by indomethacin, diclofenac, magnesium and gabapentin
ICU LOS
- Significantly decreased by four regimens
- 4
Duration of mechanical ventilation
- Significantly decreased by hydrocortisone, dexmedetomidine and clonidine
Safety
MI
- Risk decreased with magnesium; significantly increased with methylprednisolone
Original publication
Comparative Efficacy of Adjuvant Nonopioid Analgesia in Adult Cardiac Surgical Patients: A Network Meta-Analysis. J Cardiothorac Vasc Anesth. Published 18 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →