Ellenberger C, et al. – Postoperative pulmonary complications (PPCs) were specifically assessed, in addition to overall impact of using intrathecal morphine analgesia (ITMA) with minimal parenteral opioid administration in cardiac surgery patients. Application of ITMA in cardiac surgical patient was safe and associated with fewer PPCs.

Methods

• Researchers analyzed data from adult patients who underwent elective cardiac surgery between January 2002, and December 2013 in a single center.
• They used propensity scores estimating the likelihood of receiving ITMA, to match (1:1) patients with ITMA and patients with intravenous analgesia (IVA).
• Primary outcome was PPCs, a composite endpoint including pneumonia, adult respiratory distress syndrome, and any type of acute respiratory failure.
• In-hospital mortality, cardiovascular complications, and length of stay in the intensive care unit (ICU) and hospital were secondary outcomes.

Results

• Data reported that, out of a total of 1 543 patients, 920 were treated with ITMA and 623 with IVA.
• Researchers reported no adverse event consequent to the spinal puncture.
• Propensity score matching created 557 balanced pairs.
• Findings demonstrated that the occurrence of PPCs in patients with ITMA was 8.1% vs. 12.8% in patients with IVA (odds ratio, 0.6; 95% CI, 0.40–0.89; p = 0.012).
• Additionally, researchers noted that fewer patients with ITMA had a prolonged stay in the ICU (> 4 days; 16.5% vs. 21.2%, p = 0.047) or in the hospital (> 15 days; 25.5% vs. 31.8%. p = 0.024).
• Results highlighted that in-hospital mortality and cardiovascular complications did not differ significantly between the two groups.