Surgical caffeine does not reduce early postoperative opioid consumption: Study
Ann Arbor, Michigan: Intraoperative caffeine is unlikely to reduce postoperative opioid consumption, according to a recent study in the journal Anesthesia & Analgesia. However, caffeine was well-tolerated during anesthetic emergence.
Patients undergoing surgery are vulnerable to opioid dependency and related risk. Previous research has suggested that caffeine may enhance postoperative analgesia. Phillip Vlisides, Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, Michigan, and colleagues tested the hypothesis that intraoperative caffeine would reduce postoperative opioid consumption. The secondary objective was to assess whether caffeine improves neuropsychological recovery postoperatively.
For this purpose, the researchers conducted a single-center, randomized, placebo-controlled trial. It included 60 adults (≥18 years old) surgical patients (n = 65) presenting for laparoscopic colorectal and gastrointestinal surgery. They were randomized to receive either an intravenous caffeine citrate infusion (200 mg) (n=30) or dextrose 5% in water (40 mL) (n=30) during surgical closure.
The primary outcome was cumulative opioid consumption through postoperative day 3. Secondary outcomes included subjective pain reporting, observer-reported pain, delirium, Trail Making Test performance, depression and anxiety screens, and affect scores. Adverse events were reported, and hemodynamic profiles were also compared between the groups.
Key findings of the study include:
- The median (interquartile range) cumulative opioid consumption (oral morphine equivalents, milligrams) was 77 mg for caffeine and 51 mg for placebo (estimated difference, 55 mg).
- After post hoc adjustment for baseline imbalances, caffeine was associated with increased opioid consumption (87 mg).
- There were otherwise no differences in prespecified pain or neuropsychological outcomes between the groups.
- No major adverse events were reported in relation to caffeine, and no major hemodynamic perturbations were observed with caffeine administration.
"Our findings show that caffeine appears unlikely to reduce early postoperative opioid consumption. Caffeine otherwise appears well tolerated during anesthetic emergence," concluded the authors.
The study titled, "The Effects of Intraoperative Caffeine on Postoperative Opioid Consumption and Related Outcomes After Laparoscopic Surgery: A Randomized Controlled Trial," is published in the journal Anesthesia & Analgesia.