Non-steroidal Anti-inflammatory in Cardiac Surgery
Effect of Non-steroidal Anti-inflammatory Drugs in Pain Management After Cardiac Surgery
Centre Hospitalier Universitaire, Amiens
238 participants
Mar 27, 2024
INTERVENTIONAL
Summary
Non-steroidal anti-inflammatory drugs (NSAID) are part the multimodal strategy in pain management after surgery. However, major concerns are raised in cardiac surgery given the potential side effects of NSAID with more bleeding and acute kidney injury. The investigators hypothesized that NSAID are safe in the early postoperative course after cardiac surgery with respect to contraindication.
Eligibility
Inclusion Criteria4
- scheduled for cardiac surgery (aortic valve replacement, coronary artery bypass graft, mitral valve repair or replacement, intracardiac tumor, aortic root repair)
- under cardiopulmonary bypass
- Affiliation to the French national healthcare system
- Written consent obtained
Exclusion Criteria19
- age<18
- weight<50 kg
- chronic use of NSAID
- mini-invasive surgery
- NSAID contraindication
- NSAID allergy
- Nefopam contraindication
- Paracetamol contraindication
- Tramadol contraindication
- Urgent surgery
- Endocarditis
- Immunosuppressive drug
- HIV infection with CD4<200 mm3
- Organ transplantation
- Stage 4 or 5 chronic kidney disease
- Gastro duodenal ulcer
- Pregnancy
- Depression
- Auto immune disease
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Interventions
o Pain management in both arms Intraoperative time: intravenous ketamine 0.5 mg kg-1, intravenous dexamethasone 8 mg Postoperative time: paracetamol 1 g every 6 hours a day, nefopam 20 every 8 hours a day, patient control analgesia with morphine or oxycontin
Ketoprofen 100 mg twice a day, during 48 after surgery, intravenous administration
Placebo twice a day, during 48 h after surgery, intravenous administration
Locations(1)
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NCT06381063