Objective Measurement of the Mechanical Pain Threshold With an Algometer for Predicting Intraoperative Opioid Consumption in Patients Who Will be Operate by Thoracotomy and Sternotomy in Cardiac Surgery

Université Libre de Bruxelles100 enrolled

Overview

The study aims to test the relationship between the preoperative pain threshold and the intraoperative need for opioids. The objective of the study is to try to predict a patient's analgesic needs based on their objectively determined preoperative pain threshold. The investigators will include patients scheduled for elective cardiovascular surgery. The investigators will investigate the correlation between the preoperative pain threshold and intraoperative/postoperative opioid consumption in a highly standardized anesthesia setting.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

100

Conditions

Cardiac Surgery Subjects

Interventions

Measure of the minimal pain threshold with an algometer

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * ASA 3 patients with scheduled cardiac surgery by thoracotomy or sternotomy Exclusion Criteria: * Patient refusal, * A body mass index (BMI) \> 30 kg/m², * Allergies to any medication used in typical cardiac anesthesia, * Chronic pain or regular use of analgesics, * Severe ventricular dysfunction, pulmonary hypertension, poorly controlled arhythmia, * Non-elective surgery. * Patients enrolled in another study protocol within the previous 3 months, * Pregnant or breastfeeding patients, * Patients with severe renal or hepatic impairment. * Patients for whom the study will be stopped in the event of blood loss greater than or equal to one liter, or for any other severe perioperative surgical complication.

Outcomes

Primary Outcomes

Correlation between the pressure pain threshold and the consumption of opioid during and after the surgery

After the measure of the minimal pain threshold the day before the surgery, the investigators look at the quantity of Remifentanil which has been given to the patient during the surgery. Then they will look for a correlation

Time frame: From enrollment to the end of opioid administration during hospital stay, up to 6 days after the enrollment

Secondary Outcomes

Correlation between the pain threshold and the consumption of morphine during the post-operative time

After the measure of the minimal pain threshold the day before the surgery, the investigators look at the quantity of morphine which has been administrated by a PCA (Intravenous Patient-Controlled Analgesia (IV-PCA) with morphine) to the patient during the post-operative time. Then they are looking for a correlation.