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Comparative Study of Multimodal Analgesia and Morphine Analgesia Concerning the Adverse Effects Following Open-Heart Surgeries

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Last updated: 03 Jan 2025

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Abstract

Background: Historically, pain management has been based on opioid analgesics after cardiac surgeries. Opiates, however, have adverse dose-related side effects that have an impact on the recovery of patients. So, evidence-based opioids that spare multimodal analgesia are progressively being used.
Objective: To determine if the multimodal opioid-sparing treatment of dexamethasone, gabapentin, ibuprofen, ketorolac, and paracetamol had fewer side effects and was safe following open-heart surgeries compared to morphine. Patients and Methods: This prospective, double-blinded randomized, and controlled clinical study was performed on 60 patients scheduled for elective open-heart surgeries with sternotomy at Sohag University Hospital they were be randomly allocated into two equal groups, 30 patients each in the Cardiothoracic Department, Sohag University. Results: Fewer side effects occurred in patients in the multimodal group than in the morphine group. There was nausea and constipation in patients on the morphine versus multimodal group (21versus 0) with a ratio of 70% (p- value 0.001). Vomiting occurred in patients in the morphine group (12 versus 4) relative to the multimodal group with a ratio of 40% (p < /span>–value 0.020). Postoperative creatinine value showed no statistically significant difference in values between the two groups in all days, with the exception of day zero, showing lower values in the multimodal group creatinine level (0.82 ± 0.25 versus 1.02 ± 0.28 in morphine group (p-value 0.006).
Conclusions: The multimodal regimen offered lower side effects than morphine group in patients undergoing cardiac surgery. There dramatically decreased complaint of nausea, vomiting, constipation, and respiratory depression. In terms of renal complication, no safety issues were found with the multimodal regimen.

DOI

10.21608/ejhm.2020.131127

Keywords

Multimodal analgesia, Open-heart surgeries, NSAIDs, Gabapentin, morphine

Authors

First Name

Wesam Abd El Galil

Last Name

Abu Elwafa

MiddleName

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Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

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City

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Orcid

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First Name

Ahmed El Saied

Last Name

Abd Ell Rahman

MiddleName

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Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

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City

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Orcid

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First Name

Samar Thabet

Last Name

Abu Bakre

MiddleName

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Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

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City

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Orcid

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First Name

Khaled Abdelfattah Mohamed

Last Name

Abdelfattah

MiddleName

-

Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt

Email

-

City

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Orcid

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Volume

81

Article Issue

6

Related Issue

19068

Issue Date

2020-10-01

Receive Date

2020-12-19

Publish Date

2020-10-01

Page Start

2,246

Page End

2,251

Print ISSN

1687-2002

Online ISSN

2090-7125

Article File

EJHM_Volume 81_Issue 6_Pages 2246-2251.pdf

PDF . 968.9kB

Link

https://ejhm.journals.ekb.eg/article_131127.html

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https://ejhm.journals.ekb.eg/service?article_code=131127

Order

23

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Comparative Study of Multimodal Analgesia and Morphine Analgesia Concerning the Adverse Effects Following Open-Heart Surgeries

Details

Type

Article

Created At

22 Jan 2023