Can Continuous Local Anesthetic Infusion After Median Sternotomy Reduce Opioid Use?

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dc.authoridPala, Arda Aybars/0000-0001-7056-9313
dc.contributor.authorPala, Arda Aybars
dc.contributor.authorUrcun, Yusuf Salim
dc.contributor.authorCicek, Omer Faruk
dc.contributor.authorSahin, Serpil
dc.date.accessioned2025-01-27T20:20:07Z
dc.date.available2025-01-27T20:20:07Z
dc.date.issued2020
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractIntroduction Effective treatment of postoperative pain due to median sternotomy speeds up hemodynamic healing of patients. For this purpose, opioids with a wide range of side effects are widely used at high doses. The aim of this study is to investigate the effect of continuous local anesthetic (bupivacaine) infusion on opioid use on cardiac surgery patients undergoing median sternotomy. Methods A total of 215 patients undergoing isolated coronary artery bypass grafting surgery were included in the study; and 105 patients who underwent parasternal continuous local anesthetic infusion (0.5% bupivacaine at 4 mL/h, for 48h) were determined as local anesthesia group and other patients were as control group. The primary outcomes evaluated between the groups in the postoperative period were pain scores (VAS: Visual Analogic Score, PHHPS: Prince Henry Hospital Pain Score) and the number of opioids used. Secondary outcomes were mechanical ventilation time, intensive care unit and hospital stay duration, development of atrial fibrillation and atelectasis. Results Postoperative pain was found to be significantly lower in the local anesthesia group compared to the control group (VAS: 3 +/- 1.9 vs 6.4 +/- 1.8, p < 0.001; PHHPS: 0.9 +/- 0.8 vs 1.62 +/- 0.82, p < 0.001). As a result of this, opioid drug use was significantly lower in the local anesthesia group compared to the control group (0 (0 - 4) vs 1 (0 - 8), p < 0.001). Mechanical ventilation time, intensive care unit and hospital stay duration, and development of atelectasis were significantly lower in the local anesthesia group. In terms of the development of atrial fibrillation, no significant difference was found between the groups. Conclusion Parasternal continuous local anesthetic infusion reduces postoperative opioid use and speeds up hemodynamic healing by preventing possible side effects of opioids. It is a simple and effective method in the treatment of postoperative pain due to median sternotomy.
dc.identifier.doi10.7759/cureus.10711
dc.identifier.issn2168-8184
dc.identifier.issue9
dc.identifier.pmid33133875
dc.identifier.urihttps://doi.org/10.7759/cureus.10711
dc.identifier.urihttps://hdl.handle.net/20.500.12428/21574
dc.identifier.volume12
dc.identifier.wosWOS:000573369800010
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringernature
dc.relation.ispartofCureus Journal of Medical Science
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20250125
dc.subjectmedian sternotomy
dc.subjectpostoperative pain
dc.subjectopioid
dc.subjectlocal anesthesia
dc.titleCan Continuous Local Anesthetic Infusion After Median Sternotomy Reduce Opioid Use?
dc.typeArticle

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