The impact of perioperative statin-magnesium combination on opioid consumption in patients underwent cardiac surgery -Retrospective study with propensity score-matching.
CCCF ePoster library. Lee C. 11/12/19; 283414; EP70
Prof. Dr. Cheol Lee
Prof. Dr. Cheol Lee
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Abstract
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ePoster
Topic: Retrospective or Prospective Cohort Study or Case Series

1. Cheol Lee, department of anesthesiology and pain medicine, wonkwang university school of medicine, Iksan, Republic of Korea
2. Hyunho Cho, department of anesthesiology and pain medicine, wonkwang university school of medicine, Iksan, Republic of Korea
3. Cheolhyeong Lee, department of anesthesiology and pain medicine, wonkwang university school of medicine, Iksan, Republic of Korea

Background: Both statins and magnesium are associated with NMDA receptor and anti-inflammatory effect. Peripheral NMDA receptors are known to be involved in inflammation-induced pain.
Objective: This study was aimed to investigate impact of perioperative statin-magnesium combination on opioid consumption in patients underwent cardiac surgery.
Methods: This is a retrospective study based on 542 patients underwent cardiac surgery from October 2013 to December 2018. Two groups were divided according to statin use; statin-magnesium (n = 375) and no statin-magnesium (n = 167), who received perioperative magnesium to prevent postoperative atrial fibrillation in cardiac surgery. After propensity score matching, a total of 228 (n = 114, respectively) were analyzed to investigate primary outcome (opioid consumption) and secondary outcomes (visual analogue scale (VAS) pain scores for 72 hours, mechanical ventilation therapy, intensive care unit stay, pain outcomes according to duration of statin treatment (< 1 year or ≥ 1 year) or incidence of postoperative atrial fibrillation.
Results: statin-magnesium combination group in consumed PCA volume containing fentanyl (ml) for 72 hours postoperatively was significantly lower than no statin-magnesium group in both before matching (P = 0.010, 95% CI 1.6, 12.8) and after matching (P = 0.017, 95% CI 1.7, 17.2). VAS pain scores for 72 hours, mechanical ventilation therapy and ICU stay were not significant in both groups, before matching or after matching. Statin treatment (≥ 1 year) was significantly lower in consumed PCA volume than statin treatment (< 1 year) in both before matching (P = 0.047, 95% CI 0.1, 17.8) and after matching (P =0.047, 95% CI 0.1, 20.9). VAS pain scores for 72 hours in statin treatment (≥ 1 year) were significantly reduced (P < 0.05) than statin treatment (< 1 year) before matching. However, duration of statin treatment was less effective in reducing VAS pain scores for 72 hours after matching. Statin-magnesium combination didn't reduce the incidence of postoperative atrial fibrillation than no satin-magnesium group who received only magnesium before matching. However, postoperative atrial fibrillation was significantly reduced in statin-magnesium group than no stain-magnesium group.
Conclusion: statin-magnesium combination is effective in reducing opioid consumption. The duration of statin treatment may be important to improve pain outcomes. This study is small sample sized retrospective study, therefore, further studies should resolve around determining the role of statin-magnesium combination on pain outcomes.
 


Image Image Image
1. Oh TK, Chang CB, Shin HJ, Han S, Do SH, Lee HJ, Hwang JW. Association between perioperative statin use and postoperative pain after total knee arthroplasty.
Reg Anesth Pain Med. 2019 Feb;44(2):221-226. 
2. Kupetsky-Rincon EA, Uitto J.Magnesium: novel applications in cardiovascular disease--a review of the literature. Ann Nutr Metab. 2012;61(2):102-10. 
3. 
Yan J, Sun J, Huang L, Fu Q, Du G. Simvastatin prevents neuroinflammation by inhibiting N-methyl-D-aspartic acid receptor 1 in 6-hydroxydopamine-treated PC12 cells. J Neurosci Res. 2014 May;92(5):634-40.

 

 

ePoster
Topic: Retrospective or Prospective Cohort Study or Case Series

1. Cheol Lee, department of anesthesiology and pain medicine, wonkwang university school of medicine, Iksan, Republic of Korea
2. Hyunho Cho, department of anesthesiology and pain medicine, wonkwang university school of medicine, Iksan, Republic of Korea
3. Cheolhyeong Lee, department of anesthesiology and pain medicine, wonkwang university school of medicine, Iksan, Republic of Korea

Background: Both statins and magnesium are associated with NMDA receptor and anti-inflammatory effect. Peripheral NMDA receptors are known to be involved in inflammation-induced pain.
Objective: This study was aimed to investigate impact of perioperative statin-magnesium combination on opioid consumption in patients underwent cardiac surgery.
Methods: This is a retrospective study based on 542 patients underwent cardiac surgery from October 2013 to December 2018. Two groups were divided according to statin use; statin-magnesium (n = 375) and no statin-magnesium (n = 167), who received perioperative magnesium to prevent postoperative atrial fibrillation in cardiac surgery. After propensity score matching, a total of 228 (n = 114, respectively) were analyzed to investigate primary outcome (opioid consumption) and secondary outcomes (visual analogue scale (VAS) pain scores for 72 hours, mechanical ventilation therapy, intensive care unit stay, pain outcomes according to duration of statin treatment (< 1 year or ≥ 1 year) or incidence of postoperative atrial fibrillation.
Results: statin-magnesium combination group in consumed PCA volume containing fentanyl (ml) for 72 hours postoperatively was significantly lower than no statin-magnesium group in both before matching (P = 0.010, 95% CI 1.6, 12.8) and after matching (P = 0.017, 95% CI 1.7, 17.2). VAS pain scores for 72 hours, mechanical ventilation therapy and ICU stay were not significant in both groups, before matching or after matching. Statin treatment (≥ 1 year) was significantly lower in consumed PCA volume than statin treatment (< 1 year) in both before matching (P = 0.047, 95% CI 0.1, 17.8) and after matching (P =0.047, 95% CI 0.1, 20.9). VAS pain scores for 72 hours in statin treatment (≥ 1 year) were significantly reduced (P < 0.05) than statin treatment (< 1 year) before matching. However, duration of statin treatment was less effective in reducing VAS pain scores for 72 hours after matching. Statin-magnesium combination didn't reduce the incidence of postoperative atrial fibrillation than no satin-magnesium group who received only magnesium before matching. However, postoperative atrial fibrillation was significantly reduced in statin-magnesium group than no stain-magnesium group.
Conclusion: statin-magnesium combination is effective in reducing opioid consumption. The duration of statin treatment may be important to improve pain outcomes. This study is small sample sized retrospective study, therefore, further studies should resolve around determining the role of statin-magnesium combination on pain outcomes.
 


Image Image Image
1. Oh TK, Chang CB, Shin HJ, Han S, Do SH, Lee HJ, Hwang JW. Association between perioperative statin use and postoperative pain after total knee arthroplasty.
Reg Anesth Pain Med. 2019 Feb;44(2):221-226. 
2. Kupetsky-Rincon EA, Uitto J.Magnesium: novel applications in cardiovascular disease--a review of the literature. Ann Nutr Metab. 2012;61(2):102-10. 
3. 
Yan J, Sun J, Huang L, Fu Q, Du G. Simvastatin prevents neuroinflammation by inhibiting N-methyl-D-aspartic acid receptor 1 in 6-hydroxydopamine-treated PC12 cells. J Neurosci Res. 2014 May;92(5):634-40.

 

 

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