Our Summary

This study looked at the best type of anesthesia to use during a certain type of heart surgery, called “on-pump coronary artery bypass grafting”. The researchers compared a new type of anesthesia that uses less opioids (Multimodal Low-Opioid Anesthesia Protocol, or MLOP) to the standard type (Routine-Opioid Anesthesia Protocol, or ROP).

They studied 120 patients between the ages of 18 and 65 who had this surgery and split them into two groups: one group received the new, low-opioid anesthesia, and the other group received the standard type.

They then looked at several factors, such as the level of a certain protein in the blood (IL-6), how long patients needed to be on a ventilator after surgery, how long they stayed in the intensive care unit, and how long they stayed in the hospital. They also looked at the occurrence of certain complications, like low cardiac output syndrome and postoperative atrial fibrillation, which are both heart-related issues that can happen after surgery.

The results showed that the group that received the new, low-opioid anesthesia had significantly lower levels of the protein IL-6 after surgery, spent less time on a ventilator, and had a lower chance of experiencing the mentioned complications.

This suggests that the new low-opioid anesthesia might be a better option for patients undergoing this type of heart surgery.

FAQs

  1. What is the difference between the Multimodal Low-Opioid Anesthesia Protocol and the Routine-Opioid Anesthesia Protocol?
  2. What benefits did the study find with the new low-opioid anesthesia compared to the standard type?
  3. What are the potential complications that can occur after on-pump coronary artery bypass grafting surgery?

Doctor’s Tip

Therefore, if you are considering coronary artery bypass surgery, it may be beneficial to discuss with your doctor the option of using a multimodal low-opioid anesthesia protocol to potentially reduce complications and improve your recovery. It’s important to have an open and honest conversation with your healthcare team to determine the best approach for your individual situation.

Suitable For

Patients who are typically recommended for coronary artery bypass surgery are those with severe coronary artery disease, which is a condition where the blood vessels that supply blood to the heart are narrowed or blocked. These patients may experience symptoms such as chest pain, shortness of breath, or fatigue, and may have already tried other treatments such as medication or lifestyle changes without success.

Other factors that may make a patient a candidate for coronary artery bypass surgery include:

  • Multiple blockages in the coronary arteries
  • Left main coronary artery disease
  • Severe blockages in the arteries that supply blood to a large portion of the heart muscle
  • Failed previous coronary artery procedures such as angioplasty or stenting

It is important for patients to undergo a thorough evaluation by a cardiac surgeon and cardiologist to determine if coronary artery bypass surgery is the most appropriate treatment option for their specific condition.

Timeline

Before the coronary artery bypass surgery, the patient will typically undergo a series of tests and evaluations to determine the best course of treatment. This may include a physical examination, blood tests, imaging tests, and possibly a cardiac catheterization.

During the surgery, the patient will be under general anesthesia and the surgeon will make an incision in the chest to access the heart. The surgeon will then bypass the blocked or narrowed coronary arteries by grafting a healthy blood vessel from another part of the body.

After the surgery, the patient will be monitored closely in the intensive care unit for a period of time before being transferred to a regular hospital room. Recovery time can vary depending on the individual, but most patients can expect to stay in the hospital for about a week.

Following discharge from the hospital, the patient will need to follow a strict rehabilitation program to help them regain strength and endurance. This may include cardiac rehabilitation, physical therapy, and lifestyle changes such as diet and exercise.

Overall, the recovery process after coronary artery bypass surgery can take several weeks to months, and it is important for the patient to follow their healthcare provider’s instructions to ensure a successful outcome.

What to Ask Your Doctor

  1. What type of anesthesia will be used during my coronary artery bypass surgery?
  2. What are the potential benefits of the Multimodal Low-Opioid Anesthesia Protocol (MLOP) compared to Routine-Opioid Anesthesia Protocol (ROP)?
  3. Are there any specific risks or side effects associated with the MLOP anesthesia protocol?
  4. How will the choice of anesthesia impact my recovery time and overall outcome after surgery?
  5. Will I have a say in deciding which anesthesia protocol is used for my surgery?
  6. Are there any other alternative anesthesia options that I should consider?
  7. How experienced is the medical team with using the MLOP anesthesia protocol for coronary artery bypass surgery?
  8. What measures will be taken to manage pain and discomfort after surgery if the MLOP anesthesia protocol is used?
  9. How will the potential lower levels of IL-6 and reduced risk of complications benefit me in the long term?
  10. Are there any additional factors or considerations I should be aware of when choosing an anesthesia protocol for my coronary artery bypass surgery?

Reference

Authors: Stepan M, Oleh L, Oleksandr D, Justyna S. Journal: J Cardiothorac Surg. 2023 Oct 6;18(1):272. doi: 10.1186/s13019-023-02395-y. PMID: 37803334