Surgical caffeine does not reduce early postoperative opioid consumption: Study

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-06-28T09:00:23+05:30 | Updated On 28 Jun 2021 9:00 AM IST

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.

Reference:

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.

DOI: https://journals.lww.com/anesthesia-analgesia/Abstract/2021/07000/The_Effects_of_Intraoperative_Caffeine_on.30.aspx

Anesthesia & Analgesiacaffeineopioidsurgery

Source : Anesthesia & Analgesia

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751