PROSPECT provides clinicians with supporting arguments for and against the use of various interventions in postoperative pain based on published evidence and expert opinion. Clinicians must make judgements based upon the clinical circumstances and local regulations. At all times, local prescribing information for the drugs referred to must be consulted.
Pain after median sternotomy can be debilitating and difficult to treat (Lahtinen 2006; Kelava 2020). Furthermore, inadequately managed pain may increase the risk of postoperative pulmonary complications, cardiac complications and long-term complications such as poststernotomy pain syndrome (Szelkowski 2015; Bordoni 2017).
The aim of this PROSPECT review (Maeßen 2023) was to evaluate the available literature about the effects of analgesic, anaesthetic and surgical interventions on pain after cardiac surgery via median sternotomy, and to develop evidence-based, procedure-specific recommendations for pain management.
The unique PROSPECT methodology is available at https://esraeurope.org/prospect-methodology/. The methodology considers clinical practice, efficacy and adverse effects of analgesic techniques.
Literature databases were searched up to November 2020.
COX, cyclooxygenase; NSAID, non-steroidal anti-inflammatory drug.
NSAIDs, non-steroidal anti-inflammatory drugs.
PROSPECT guideline for cardiac surgery via median sternotomy-infographic