Wang Q, Yan XQ, Ma XM, Yan R, Wang ZH, Ma YJ, Wang HB. Multimodal analgesia in cardiac surgery: Impact on postoperative medication consumption and cognitive function. World J Cardiol 2025; 17(5): 103168 [PMID: 40496392 DOI: 10.4330/wjc.v17.i5.103168]
Corresponding Author of This Article
Hai-Bin Wang, Chief Physician, Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, No. 804 Shengli South Street, Xingqing District, Yinchuan 750000, Ningxia Hui Autonomous Region, China. haibinwang2024@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Randomized Controlled Trial
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Wang Q, Yan XQ, Ma XM, Yan R, Wang ZH, Ma YJ, Wang HB. Multimodal analgesia in cardiac surgery: Impact on postoperative medication consumption and cognitive function. World J Cardiol 2025; 17(5): 103168 [PMID: 40496392 DOI: 10.4330/wjc.v17.i5.103168]
Qin Wang, Xiao-Qiong Yan, Xiao-Mei Ma, Rui Yan, Zhi-Hua Wang, Yu-Jie Ma, Hai-Bin Wang, Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
Co-first authors: Qin Wang and Xiao-Qiong Yan.
Author contributions: Wang Q, Yan XQ, Ma XM, and Wang HB designed the research study; Wang Q, Yan XQ, and Wang HB wrote the first draft of the manuscript and performed the experiments; Yan R, Wang ZH, and Ma YJ created the figures; Wang Q and Wang HB revised the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ningxia Medical University General Hospital Medical Research Ethics Review Committee, with the reference number of KYLL-2024-1348 and conducted in accordance with the ethical standards of the Declaration of Helsinki.
Clinical trial registration statement: The study was registered at the Clinical Trial Center (http://www.researchregistry.com) with registration number of Researchregistry11118.
Informed consent statement: All participants provided written informed consent to participate after being fully informed about the study’s objectives, procedures, potential risks, benefits, and confidentiality measures.
Conflict-of-interest statement: The authors declared that they have no conflicts of interest regarding this work.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: All data generated or analyzed during this study are included in this published article. Additional data related to this research are available from the corresponding author upon reasonable request.
Corresponding author: Hai-Bin Wang, Chief Physician, Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, No. 804 Shengli South Street, Xingqing District, Yinchuan 750000, Ningxia Hui Autonomous Region, China. haibinwang2024@163.com
Received: November 11, 2024 Revised: March 23, 2025 Accepted: April 25, 2025 Published online: May 26, 2025 Processing time: 193 Days and 18.7 Hours
Abstract
BACKGROUND
Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues. Multimodal analgesia may address these problems. We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.
AIM
To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.
METHODS
A prospective, randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery. The patients were randomly divided into two groups. Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil. Group B had flurbiprofen axil and paravertebral nerve block. Data were analyzed with appropriate statistical methods.
RESULTS
Group B had lower postoperative patient-controlled intravenous analgesia drug consumption (2.21 mL/hour vs 4.26 mL/hour, P < 0.001), shorter extubation time (2.32 hours vs 3.81 hours, P < 0.001), and intensive care unit stay (15.32 h vs 28.63 h, P < 0.001). Visual Analogue Scale pain scores were lower in group B (P < 0.001). Group B had fewer postoperative complications (no respiratory depression vs 37.9% in group A, P < 0.05), a lower postoperative cognitive dysfunction incidence (16.0% vs 28.0%, P < 0.05), and higher Barthel Index scores (P < 0.05).
CONCLUSION
Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.
Core Tip: In this study, 150 patients who underwent cardiac surgery were randomized into two groups. The combination of paravertebral nerve block and flurbiprofen axil in multimodal analgesia significantly reduced postoperative opioid use and enhanced cognitive function. It offered a better pain management and recovery approach.
