Anesthesiologists’ Intraoperative Analgesic Practices for Patients Undergoing Cardiac Surgery

Objectives: We aimed to ascertain the international practice patterns of cardiac anesthesiologists pertaining to analgesic prescription in the intraoperative period for patients undergoing cardiac surgery. Design: Survey was conducted in 2024. Setting: International, focusing on Australia, New Zealand, and North America. Participants: Members of the Society of Cardiovascular Anesthesiologists and members of the Cardiac, Thoracic, Vascular and Perfusion Special Interest Group of the Australian & New Zealand College of Anaesthetists. The Society of Cardiovascular Anesthesiologists distributed the survey among its 2,134 members, and the Australian & New Zealand College of Anaesthetists Clinical Trials Network distributed it to its 802 members. Interventions: None. Measurements: Perceptions and practice patterns regarding opioid and non-opioid analgesic practices within the intraoperative cardiac surgery period. Main Results: There were 377 participants who responded, with fentanyl being the primary opioid analgesic of choice (73.5%), and acetaminophen (72.3%) being the adjunct of choice. Most respondents agree that there is a role for intraoperative multimodal analgesia in cardiac surgery (79.1%). Conventional practice was principally mentioned as a barrier to utilizing an opioid-sparing technique (50%), followed by a lack of institutional policy (35.1%), and a lack of familiarity or comfort with the technique (34.8%) Conclusions: The efficacy of non-opioid drugs, in addition to comparisons between opioids, needs to be further established with longer-term, patient-centered clinical outcomes in mind. Educational and institutional policy interventions may play a ole in standardizing the use of intraoperative opioid use.