Multimodal Analgesia Versus Traditional Opiate Based Analgesia
Status:
Unknown status
Trial end date:
2019-12-30
Target enrollment:
Participant gender:
Summary
Pain after cardiac surgery can be moderate to severe with incisions to the sternum and lower
extremities, and also the placement of chest tubes. Postoperative pain may contribute to
delirium, stress, myocardial oxygen demand supply imbalance, etc. Traditionally postoperative
pain management after cardiac surgery has been based on opiate analgesics. However, opiates
have many deleterious side effects including nausea/vomiting, ileus, bladder dysfunction, and
respiratory depression, which substantially influence patient recovery and may delay
discharge after surgery.
The current study is designed to evaluate if an opiate sparing multimodal regimen of tylenol,
gabapentin, ketamine, lidocaine and dexmedetomidine provided better analgesic effect (pain
score, postoperative PCA opioid dose), less side effects (PONV) and improved cardiac surgery
outcome (delirium, a-fib, AKI, dysglycemia) compared to a traditional fentanyl and
hydromorphine regimen after cardiac surgery. Additionally, it aims to investigate if the
benefit of multimodal regimen is achieved by combination of all drugs or all drugs except
dexmedetomodine by introducing third group of study patients who will be randomized to all
interventions except saline placebo instead of dexmedetomodine infusion.