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Abstract
Background and Aims POP in cardiac surgery is often overlooked, being moderate to severe in up to 75% of patients. Moreover, 35% of patients report persistent thoracic pain one year post surgery. SSTS is a handheld PCA device that delivers a fixed dose of 15 mcg sufentanil tablets on a PRN basis. We evaluated clinical application of SSTS for POP relief after OPCABG, assessing effectiveness, safety, and patient satisfaction.
Methods Observational case series on 20 patients who underwent OPCABG. POP was managed by the exclusive use of SSTS. Prior to the end of surgery, paracetamol 1 g, sufentanil 0.15–0.2 mcg/kg, ondansetron 4 mg were administered. Efficacy was assessed by patient reports of pain intensity on numerical rating scale (NRS). Safety assessments included vital signs. Patient satisfaction was assessed via the Patient Global Assessment (PGA) of method of pain control, with ‘success’ defined as the proportion of patients responding ‘good’ or ‘excellent’.
Results Average patient age was 61 years, BMI was 26.6. Mean number of doses was 20 (range 8–52) over 72 hours, with inter-dosing intervals of 159 minutes. Median NRS was 1 (range 0–4) at rest, and 2 (range 0–6) during movement. No desaturation (SpO2 < 92%) was found. PGA scores showed a success rate of 91%. Neither harvesting nor cannulation of the radial artery of the dominant limb limited the use of SSTS.
Conclusions SSTS has proved an effective and safe device for POP relief after OPCABG. To the best of our knowledge, this is the first report of SSTS use in OPCABG patients.