From the Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, Ohio.
Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina.
Anesth Analg. 2023 Jul 1;137(1):26-47. doi: 10.1213/ANE.0000000000006506. Epub 2023 Jun 16.
Pain after cardiac surgery is of moderate to severe intensity, which increases postoperative distress and health care costs, and affects functional recovery. Opioids have been central agents in treating pain after cardiac surgery for decades. The use of multimodal analgesic strategies can promote effective postoperative pain control and help mitigate opioid exposure. This Practice Advisory is part of a series developed by the Society of Cardiovascular Anesthesiologists (SCA) Quality, Safety, and Leadership (QSL) Committee's Opioid Working Group. It is a systematic review of existing literature for various interventions related to the preoperative and intraoperative pain management of cardiac surgical patients. This Practice Advisory provides recommendations for providers caring for patients undergoing cardiac surgery. This entails developing customized pain management strategies for patients, including preoperative patient evaluation, pain management, and opioid use-focused education as well as perioperative use of multimodal analgesics and regional techniques for various cardiac surgical procedures. The literature related to this field is emerging, and future studies will provide additional guidance on ways to improve clinically meaningful patient outcomes.
心脏手术后的疼痛为中重度，增加术后痛苦和医疗保健费用，并影响功能恢复。几十年来，阿片类药物一直是心脏手术后治疗疼痛的主要药物。多模式镇痛策略的使用可以促进有效的术后疼痛控制，并有助于减少阿片类药物的暴露。本实践指南是心血管麻醉师学会（SCA）质量、安全和领导力（QSL）委员会阿片类药物工作组制定的一系列指南的一部分。它对与心脏手术患者围手术期疼痛管理相关的各种干预措施的现有文献进行了系统评价。本实践指南为心脏手术患者的护理人员提供了建议。这需要为患者制定定制化的疼痛管理策略，包括术前患者评估、疼痛管理以及针对围手术期使用的阿片类药物和各种心脏手术的区域技术的教育。与该领域相关的文献正在不断涌现，未来的研究将为改善有临床意义的患者结局提供更多指导。
