Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study
Abstract 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 th...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02395-y |
| _version_ | 1797556496580476928 |
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| author | Maruniak Stepan Loskutov Oleh Druzhyna Oleksandr Swol Justyna |
| author_facet | Maruniak Stepan Loskutov Oleh Druzhyna Oleksandr Swol Justyna |
| author_sort | Maruniak Stepan |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-10T17:03:45Z |
| format | Article |
| id | doaj.art-3d70b5de6dee447296d77107739d14dd |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-10T17:03:45Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-3d70b5de6dee447296d77107739d14dd2023-11-20T10:52:49ZengBMCJournal of Cardiothoracic Surgery1749-80902023-10-0118111110.1186/s13019-023-02395-yEffects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort studyMaruniak Stepan0Loskutov Oleh1Druzhyna Oleksandr2Swol Justyna3Department of Extracorporeal Methods of Treatment, Heart Institute Ministry of Health of UkraineDepartment of Extracorporeal Methods of Treatment, Heart Institute Ministry of Health of UkraineDepartment of Extracorporeal Methods of Treatment, Heart Institute Ministry of Health of UkraineDepartment of Respiratory Medicine, Paracelsus Medical UniversityAbstract 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.https://doi.org/10.1186/s13019-023-02395-yCoronary artery bypass graftingCardiopulmonary bypassMultimodal low-opioid anesthesia protocolIL-6Low cardiac output syndromePostoperative atrial fibrillation |
| spellingShingle | Maruniak Stepan Loskutov Oleh Druzhyna Oleksandr Swol Justyna Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study Journal of Cardiothoracic Surgery Coronary artery bypass grafting Cardiopulmonary bypass Multimodal low-opioid anesthesia protocol IL-6 Low cardiac output syndrome Postoperative atrial fibrillation |
| title | Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study |
| title_full | Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study |
| title_fullStr | Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study |
| title_full_unstemmed | Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study |
| title_short | Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study |
| title_sort | effects of multimodal low opioid anesthesia protocol during on pump coronary artery bypass grafting a prospective cohort study |
| topic | Coronary artery bypass grafting Cardiopulmonary bypass Multimodal low-opioid anesthesia protocol IL-6 Low cardiac output syndrome Postoperative atrial fibrillation |
| url | https://doi.org/10.1186/s13019-023-02395-y |
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