Key result
A multimodal low-opioid anesthesia protocol significantly reduced the incidence of low cardiac output syndrome (11.7% vs. 26.7%) and postoperative atrial fibrillation compared to a routine-opioid protocol in patients undergoing on-pump CABG.
Why the study?
The most favorable anesthesia protocol during on-pump CABG remains unclear, despite known interactions between anesthesia protocols and postoperative complications.
Does a multimodal low-opioid anesthesia protocol reduce IL-6 levels and postoperative complications compared to a routine-opioid protocol in patients undergoing on-pump CABG?
Cohort (n=120)
No
Does a multimodal low-opioid anesthesia protocol reduce IL-6 levels and postoperative complications compared to a routine-opioid protocol in patients undergoing on-pump CABG?
Absolute Event Rate: 11.7% vs 26.7%
p-value: p=0.037
A multimodal low-opioid anesthesia protocol during on-pump CABG significantly reduces postoperative IL-6 levels, mechanical ventilation duration, and the incidence of low cardiac output syndrome and atrial fibrillation compared to a routine opioid protocol.
Multimodal low-opioid anesthesia was associated with fewer CABG complications; leaves open efficacy pending randomized confirmation.
BACKGROUND: The most favorable anesthesia protocol during on-pump coronary artery bypass grafting (CABG) in patients with coronary heart disease remains unclear, despite previous publications regarding the interaction between anesthesia protocol and postoperative complications. The aim of the study was to compare the effect of a multimodal low-opioid anesthesia protocol (MLOP) on early postoperative complications during on-pump CABG. METHODS: A single-center prospective cohort study including 120 patients undergoing on-pump CABG aged 18 to 65 years, divided into two groups according to undergoing MLOP or routine-opioid anesthesia protocol (ROP). The analyzed parameters were plasma IL-6 levels, complications, duration of mechanical ventilation, length of intensive care unit stay, and hospitalization. RESULTS: In the MLOP group, the levels of IL-6 at the end of the surgery were 25.6% significantly lower compared to the ROP group (33.4 ± 9.4 vs. 44.9 ± 15.9, p < 0.0001), the duration of mechanical ventilation was significantly shorter (2.0 (2.0; 3.0) h vs. 4.0 (3.0; 5.0) h, p < 0.001), the incidence of low cardiac output syndrome was almost two and half times lower (7 (11.7%) vs. 16 (26.7%), p = 0.037), and also the incidence of postoperative atrial fibrillation was significantly lower (9 (15.0%) vs. 19 (31.7%), p = 0.031). CONCLUSION: Our study confirms that using MLOP was characterized by significantly lower levels of IL-6 at the end of surgery and a lower incidence of low cardiac output syndrome and postoperative atrial fibrillation than ROP. TRIAL REGISTRATION: The study is registered in clinicaltrials.gov №NCT05514652.
No takes yet. Share an insight, caveat, or question.
Stepan et al. (2023) conducted a cohort in Coronary heart disease (n=120). Multimodal low-opioid anesthesia protocol (MLOP) vs. Routine-opioid anesthesia protocol (ROP) was evaluated on Incidence of low cardiac output syndrome (LCOS) (p=0.037). A multimodal low-opioid anesthesia protocol significantly reduced the incidence of low cardiac output syndrome (11.7% vs. 26.7%) and postoperative atrial fibrillation compared to a routine-opioid protocol in patients undergoing on-pump CABG.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: