Cardiothoracic & vascular anesthesia
Multimodal Analgesia and Enhanced Recovery Outcomes in Cardiac Surgical Patients: An Observational Cohort Study
Main findingResult — go to the resultb −0.07 95% CI −0.32 to 0.18Authors' conclusion
In this retrospective study, multimodal analgesia was not associated with the primary outcome of reduction in maximum pain score but was associated with more rapid extubation.
Study context
- Population
- Adults undergoing elective coronary artery bypass grafting (CABG), valve, or combined CABG-valve surgery, 2020–2023
- Participants
- 17,371 eligible cardiac surgical cases
- Exposure
- Multimodal analgesia vs no multimodal analgesia
- Multimodal analgesian = 15,515
- Outcome
- Maximum postoperative pain score
- Follow-up
- POD3
Methodological detailsSociety of Thoracic Surgeons database, mixed-effects regression adjusted for confounders
- Society of Thoracic Surgeons database
- Mixed-effects regression adjusted for confounders
Main finding
As reported in the abstract
b
−0.07
95% CI −0.32 to 0.18
P = 0.57
Observational data: associations, not effects.
Further findings
Delirium (acetaminophen use)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Acetaminophen | 0.75 (0.57–0.94) | P = 0.02 | |
| 0.512Odds ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Initial mechanical ventilation hours≈30 minutes longer without multimodal analgesia | b 0.45 hours (95% CI 0.04–0.86) | P = 0.03 |
| Initial mechanical ventilation time by number of multimodal analgesics1 multimodal analgesic | b −0.33 hours (95% CI −76 to −0.10) | P = 0.14 |
| Initial mechanical ventilation time by number of multimodal analgesics5 multimodal analgesics | Est −1.98 hours (95% CI −3.79 to −0.18) | P = 0.03 |
Initial mechanical ventilation time by number of multimodal analgesics
- Ventilation time decreased as the number of multimodal analgesics increased
Safety
Unplanned reintubation (regional nerve block use)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Regional nerve block | 1.59 (1.12–2.27) | P = 0.01 | |
| 0.512Odds ratio (log scale) |
Original publication
Multimodal Analgesia and Enhanced Recovery Outcomes in Cardiac Surgical Patients: An Observational Cohort Study. Anesth Analg. Published 25 June 2025. doi:10.
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