Opioid-sparing Anesthesia Significantly Improves Early Postoperative Recovery after Cardiac Surgery: A Retrospective Cohort Study

Background: Mounting evidence indicates that opioid-sparing anesthesia (OSA) decreases opioid-related adverse events. Our goal was to determine whether OSA might improve initial recovery after cardiac surgery. Methods: Data from patients who underwent elective heart surgery between July 2023 and July 2024 were analyzed. Eligible patients were divided into an OSA group or a control group. Patients in the OSA group received 0.5 to 1 mu g<middle dot>kg(-1 )sufentanil and ultrasound-guided nerve block after anesthetic induction, whereas patients in the control group received traditional high-dose opioid management. Patients in both groups were managed with the same sedatives, muscle relaxants, and other drugs. The main outcome was the overall 15-item Quality of Recovery (QoR-15) survey score 24 hours after surgery. Results: A total of 1916 patients were scanned, and 1218 patients were included in the analysis: 392 in the OSA group and 826 in the control group. The QoR-15 global score measured 24 hours after surgery was 119.29 +/- 3.25 in the OSA group and 113.87 +/- 3.44 in the control group (P < 0.001). The OSA group had lower numeric rating scale scores 24 hours and 72 hours after surgery (P < 0.001) than the control group. The median (interquartile range) postoperative mechanical ventilation time was 1.0 (0-5) hours in the OSA group and 8.0 (6-14) hours in the control group (P < 0.001), and the duration of hospitalization was 11.5 (9-14) days and 12 (10-14) days, respectively (P = 0.012). Conclusion: OSA based on ultrasound-guided nerve blocks significantly improved QoR-15 scores after cardiac surgery and is expected to be a reasonable analgesic protocol to improve the prognosis of cardiac patients.