Efficiency and safety of Tapentadol with immediate release for postoperative analgesia in cardiac surgery patients

Abstract

The objective was to evaluate the efficacy and safety of the use of a tablet form of Tapentadol central analgesic for postoperative analgesia in cardiac surgery patients.Materials and methods. In the observational study, the scheme of postoperative analgesia of the tablet form of Tapentadol with immediate release was evaluated. The drug was used in 20 patients after various cardiac surgical interventions. The intensity of the pain syndrome during the patient’s motor activity (cough, deep breath) and at rest was assessed on a 100 mm visual analogue scale (VAS). As an additional objective criterion for the effectiveness of analgesia, the method of incentive spirometry was used. Analgesia was performed for 2 to 4 postoperative days. Basic analgesia: tablet form of Tapentadol of 50 mg 2 times a day. Additional analgesia: Ketoprofen «on demand» intravenously at a dose of 100 mg (depending on the severity of the pain syndrome at VAS > 40 mm). Therapy was started in the ICU, then, continued after transfer to the specialized surgical department.Results. On the second postoperative day, the average pain intensity was higher, within 30 mm of VAS (mild pain), however, 35% of patients had high values (from 50 to 70 mm), and therefore additional Ketoprofen analgesia at a dose of 100 mg was required. In the following postoperative days, after the removal of drains, the average severity of the pain syndrome was lower, within 15–17mm according to VAS and additional anesthesia was not required. The analgesic effect of Tapentadol had a positive effect on the respiratory function with an increase in maximum inspiratory lung capacity (MILC) by 1.5 times from the beginning of the study. Adverse events typical of opioid analgesics, such as nausea, weakness, drowsiness, intestinal paresis, were noted in a minimal number of patients and passed without discontinuation of the drug.Conclusion. The high analgesic effect has been demonstrated, as well as a good safety profile of using the minimum daily dose of the tablet form of the drug Tapentadol in the early postoperative period after cardiac surgery.