Methylprednisolone Does Not Reduce Persistent Pain after Cardiac Surgery
| Autor: | Jean Francois Legare, Rachel van Oostveen, Antoine Rochon, Alistair Royse, Emilie P. Belley-Côté, Gustavo Cordova, Jean Pierre Yared, Sabry Ayad, Mackenzie A. Quantz, Salim Yusuf, Daniel I. Sessler, Hai Yu, Andre Lamy, Alparslan Turan, Vivian Nasr, Philip J. Devereaux, Richard P. Whitlock, Jessica Vincent |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Pain medicine Analgesic Anti-Inflammatory Agents Placebo Methylprednisolone law.invention Sex Factors Randomized controlled trial Risk Factors law medicine Humans Cardiac Surgical Procedures Aged Pain Postoperative Cardiopulmonary Bypass business.industry Age Factors Chronic pain medicine.disease Surgery Cardiac surgery Treatment Outcome Anesthesiology and Pain Medicine Median sternotomy Anesthesia Female business Follow-Up Studies medicine.drug |
| Zdroj: | Anesthesiology. 123:1404-1410 |
| ISSN: | 0003-3022 |
| Popis: | Background Persistent incisional pain is common after cardiac surgery and is believed to be in part related to inflammation and poorly controlled acute pain. Methylprednisolone is a corticosteroid with substantial antiinflammatory and analgesic properties and is thus likely to ameliorate persistent surgical pain. Therefore, the authors tested the primary hypothesis that patients randomized to methylprednisolone have less persistent incisional pain than those given placebo. Methods One thousand forty-three patients having cardiopulmonary bypass for cardiac surgery via a median sternotomy were included in this substudy of Steroids in Cardiac Surgery (SIRS) trial. Patients were randomized to 500 mg intraoperative methylprednisolone or placebo. Incisional pain was assessed at 30 days and 6 months after surgery, and the potential risk factors were also evaluated. Results Methylprednisolone administration did not reduce pain at 30 days or persistent incisional pain at 6 months, which occurred in 78 of 520 patients (15.7%) in the methylprednisolone group and in 88 of 523 patients (17.8%) in the placebo group. The odds ratio for methylprednisolone was 0.93 (95% CI, 0.79 to 1.09, P = 0.37). Furthermore, there was no difference in worst pain and average pain in the last 24 h, pain interference with daily life, or use of pain medicine at 6 months. Younger age, female sex, and surgical infections were associated with the development of persistent incisional pain. Conclusions Intraoperative methylprednisolone administration does not reduce persistent incisional pain at 6 months in patients recovering from cardiac surgery. |
| Databáze: | OpenAIRE |
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