The year 2020 was marred by the emergence of a deadly pandemic that disrupted every aspect of life. Despite the disruption, notable research accomplishments in the practice of cardiothoracic anesthesiology occurred in 2020 with an emphasis on optimizing care, improving outcomes, and expanding what is possible for patients undergoing cardiac surgery. This year’s edition of Noteworthy Literature Review will focus on specific themes in cardiac anesthesiology that include preoperative anemia, predictors of acute kidney injury following cardiac surgery, pain management modalities, anticoagulation strategies after transcatheter aortic valve replacement, mechanical circulatory support, and future directions in research.
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2.
TankardKAParkBBrovmanEYBaderAMUrmanRD.The impact of preoperative intravenous iron therapy on perioperative outcomes in cardiac surgery: a systematic review. J Hematol. 2020;9:97-108. doi:10.14740/jh696
3.
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FroesslerBPalmPWeberIHodylNASinghRMurphyEM.The important role for intravenous iron in perioperative patient blood management in major abdominal surgery. Ann Surg. 2016;264:41-46. doi:10.1097/SLA.0000000000001646
5.
CuencaJGarcía-ErceJAMartínezFPérez-SerranoLHerreraAMuñozM.Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery. Transfusion. 2006;46:1112-1119. doi:10.1111/j.1537-2995.2006.00859.x
6.
HigginsJPTThomasJChandlerJ, et al. Cochrane Handbook for Systematic Reviews of Interventions. John Wiley; 2019.
JohanssonPIRasmussenASThomsenLL.Intravenous iron isomaltoside 1000 (Monofer®) reduces postoperative anaemia in preoperatively non-anaemic patients undergoing elective or subacute coronary artery bypass graft, valve replacement or a combination thereof: a randomized double-blind placebo-controlled clinical trial (the PROTECT trial). Vox Sang. 2015;109:257-266. doi:10.1111/vox.12278
9.
SpahnDRSchoenrathFSpahnGH, et al. Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. Lancet. 2019;393:2201-2212. doi:10.1016/S0140-6736(18)32555-8
10.
CladellasMFarréNComín-ColetJ, et al. Effects of preoperative intravenous erythropoietin plus iron on outcome in anemic patients after cardiac valve replacement. Am J Cardiol. 2012;110:1021-1026. doi:10.1016/j.amjcard.2012.05.036
11.
PadmanabhanHSiauKNevillAM, et al. Intravenous iron does not effectively correct preoperative anaemia in cardiac surgery: a pilot randomized controlled trial. Interact Cardiovasc Thorac Surg. 2019;28:447-454. doi:10.1093/icvts/ivy226
12.
Garrido-MartínPNassar-MansurMIde la Llana-DucrósR, et al. The effect of intravenous and oral iron administration on perioperative anaemia and transfusion requirements in patients undergoing elective cardiac surgery: a randomized clinical trial. Interact Cardiovasc Thorac Surg. 2012;15:1013-1018. doi:10.1093/icvts/ivs344
13.
UrenaMDel TrigoMAltisentOAJ, et al. Combined erythropoietin and iron therapy for anaemic patients undergoing transcatheter aortic valve implantation: the EPICURE randomised clinical trial. EuroIntervention. 2017;13:44-52. doi:10.4244/eij-d-16-00591
14.
RaphaelJMazerCDSubramaniS, et al. Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for management of perioperative bleeding and hemostasis in cardiac surgery patients. J Cardiothorac Vasc Anesth. 2019;33:2887-2899. doi:10.1053/j.jvca.2019.04.003
15.
MeybohmPWestphalSRavnHB, et al. Perioperative anemia management as part of PBM in cardiac surgery—a narrative updated review. J Cardiothorac Vasc Anesth. 2020;34:1060-1073. doi:10.1053/j.jvca.2019.06.047
SchunkSJZarbockAMeerschM, et al. Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. Lancet. 2019;394:488-496. doi:10.1016/S0140-6736(19)30769-X
18.
ZaouterCPotvinJBatsMLBeauvieuxMCRemyAOuattaraA.A combined approach for the early recognition of acute kidney injury after adult cardiac surgery. Anaesth Crit Care Pain Med. 2018;37:335-341. doi:10.1016/j.accpm.2018.05.001
19.
CummingsJJShawADShiJLopezMGO’NealJBBillingsFT4th. Intraoperative prediction of cardiac surgery-associated acute kidney injury using urinary biomarkers of cell cycle arrest. J Thorac Cardiovasc Surg. 2019;157:1545-1553.e5. doi:10.1016/j.jtcvs.2018.08.090
20.
MayerTBolligerDScholzM, et al. Urine biomarkers of tubular renal cell damage for the prediction of acute kidney injury after cardiac surgery—a pilot study. J Cardiothorac Vasc Anesth. 2017;31:2072-2079. doi:10.1053/j.jvca.2017.04.024
21.
HayekSSLeafDETahhanAS, et al. Soluble urokinase receptor and acute kidney injury. N Engl J Med. 2020;382:416-426. doi:10.1056/NEJMoa1911481
22.
BaxterRSquiersJConnerW, et al. Enhanced recovery after surgery: a narrative review of its application in cardiac surgery. Ann Thorac Surg. 2020;109:1937-1944. doi:10.1016/j.athoracsur.2019.11.008
23.
KimBJAloiaTA.What is “enhanced recovery,” and how can I do it?J Gastrointest Surg. 2018;22:164-171. doi:10.1007/s11605-017-3605-9
24.
BarrAMTutungiEAlmeidaAA.Parasternal intercostal block with ropivacaine for pain management after cardiac surgery: a double-blind, randomized, controlled trial. J Cardiothorac Vasc Anesth. 2007;21:547-553. doi:10.1053/j.jvca.2006.09.003
25.
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26.
AmodeoGBugadaDFranchiS, et al. Immune function after major surgical interventions: the effect of postoperative pain treatment. J Pain Res. 2018;11:1297-1305. doi:10.2147/JPR.S158230
27.
KehletHJensenTSWoolfCJ.Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618-1625. doi:10.1016/S0140-6736(06)68700-X
28.
BarlettaJF.Clinical and economic burden of opioid use for postsurgical pain: focus on ventilatory impairment and ileus. Pharmacotherapy. 2012;32(9 suppl):12S-18S. doi:10.1002/j.1875-9114.2012.01178.x
29.
MauermannERuppenWBandschappO.Different protocols used today to achieve total opioid-free general anesthesia without locoregional blocks. Best Pract Res Clin Anaesthesiol. 2017;31:533-545. doi:10.1016/j.bpa.2017.11.003
30.
GrantMCIsadaTRuzankinP, et al. Opioid-sparing cardiac anesthesia: secondary analysis of an enhanced recovery program for cardiac surgery. Anesth Analg. 2020;131:1852-1861. doi:10.1213/ANE.0000000000005152
31.
KarPRamachandranG.Pain relief following sternotomy in conventional cardiac surgery: a review of non neuraxial regional nerve blocks. Ann Card Anaesth. 2020;23:200-208. doi:10.4103/aca.ACA_241_18
32.
LeeCYRobinsonDAJohnsonCA, et al. A randomized controlled trial of liposomal bupivacaine parasternal intercostal block for sternotomy. Ann Thorac Surg. 2019;107:128-134. doi:10.1016/j.athoracsur.2018.06.081
33.
NagarajaPSRagavendranSSinghNG, et al. Comparison of continuous thoracic epidural analgesia with bilateral erector spinae plane block for perioperative pain management in cardiac surgery. Ann Card Anaesth. 2018;21:323-327. doi:10.4103/aca.ACA_16_18
34.
GadsdenJ.The erector spinae plane block: the case of the elusive mechanism of action. Can J Anaesth. 2021;68:288-292. doi:10.1007/s12630-020-01876-1
35.
ScarfeAJSchuhmann-HingelSDuncanJKMaNAtukoraleYNCameronAL.Continuous paravertebral block for post-cardiothoracic surgery analgesia: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2016;50:1010-1018. doi:10.1093/ejcts/ezw168
36.
El ShoraHAEl BeleehyAAAbdelwahabAA, et al. Bilateral paravertebral block versus thoracic epidural analgesia for pain control post-cardiac surgery: a randomized controlled trial. Thorac Cardiovasc Surg. 2020;68:410-416. doi:10.1055/s-0038-1668496
37.
OkajimaHTanakaOUshioM, et al. Ultrasound-guided continuous thoracic paravertebral block provides comparable analgesia and fewer episodes of hypotension than continuous epidural block after lung surgery. J Anesth. 2015;29:373-378. doi:10.1007/s00540-014-1947-y
38.
HorlockerTTVandermeuelenEKoppSLGogartenWLeffertLRBenzonHT.Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition). Reg Anesth Pain Med. 2018;43:263-309. doi:10.1097/AAP.0000000000000763
39.
ClendenenNAbramsBMorabitoJGraeLMoscaMSWeitzelN.Noteworthy literature in cardiac anesthesia for 2019. Semin Cardiothorac Vasc Anesth. 2020;24:138-148. doi:10.1177/1089253220921588
40.
YuHXuZDaiSH, et al. The effect of propofol versus volatile anesthetics on persistent pain after cardiac surgery: a randomized controlled trial. J Cardiothorac Vasc Anesth. Published online October 19, 2020. doi:10.1053/j.jvca.2020.10.025
41.
QiuQChoiSWWongSSCIrwinMGCheungCW.Effects of intra-operative maintenance of general anaesthesia with propofol on postoperative pain outcomes—a systematic review and meta-analysis. Anaesthesia. 2016;71:1222-1233. doi:10.1111/anae.13578
42.
PengKLiuHYWuSRLiuHZhangZCJiFH.Does propofol anesthesia lead to less postoperative pain compared with inhalational anesthesia? A systematic review and meta-analysis. Anesth Analg. 2016;123:846-858. doi:10.1213/ANE.0000000000001504
43.
OgurluMSariSKüçükM, et al. Comparison of the effect of propofol and sevoflurane anaesthesia on acute and chronic postoperative pain after hysterectomy. Anaesth Intensive Care. 2014;42:365-370. doi:10.1177/0310057X1404200314
44.
SongJGShinJWLeeEH, et al. Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia. Eur J Cardiothorac Surg. 2012;41:1078-1082. doi:10.1093/ejcts/ezr133
45.
BrownCRChenZKhurshanFGroeneveldPWDesaiND.Development of persistent opioid use after cardiac surgery. JAMA Cardiol. 2020;5:889-896. doi:10.1001/jamacardio.2020.1445
46.
ReddiDCurranN.Chronic pain after surgery: pathophysiology, risk factors and prevention. Postgrad Med J. 2014;90:222-227. doi:10.1136/postgradmedj-2013-132215
47.
BrummettCMWaljeeJFGoeslingJ, et al. New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg. 2017;152:e170504. doi:10.1001/jamasurg.2017.0504
48.
WebsterLR.Risk factors for opioid-use disorder and overdose. Anesth Analg. 2017;125:1741-1748. doi:10.1213/ANE.0000000000002496
49.
D’SouzaRSGurrieriCJohnsonRLWarnerNWittwerE.Intraoperative methadone administration and postoperative pain control: a systematic review and meta-analysis. Pain. 2020;161:237-243. doi:10.1097/j.pain.0000000000001717
50.
MurphyGSAvramMJGreenbergSB, et al. Postoperative pain and analgesic requirements in the first year after intraoperative methadone for complex spine and cardiac surgery. Anesthesiology. 2020;132:330-342. doi:10.1097/ALN.0000000000003025
51.
AlthausABeckerOAMoserKH, et al. Postoperative pain trajectories and pain chronification—an empirical typology of pain patients. Pain Med. 2018;19:2536-2545. doi:10.1093/pm/pny099
52.
FletcherDStamerUMPogatzki-ZahnE, et al. Chronic postsurgical pain in Europe: an observational study. Eur J Anaesthesiol. 2015;32:725-734. doi:10.1097/EJA.0000000000000319
53.
DangasGDTijssenJGPWöhrleJ, et al. A controlled trial of rivaroxaban after transcatheter aortic-valve replacement. N Engl J Med. 2020;382:120-129. doi:10.1056/NEJMoa1911425
54.
De BackerODangasGDJilaihawiH, et al. Reduced leaflet motion after transcatheter aortic-valve replacement. N Engl J Med. 2020;382:130-139. doi:10.1056/NEJMoa1911426
55.
BrouwerJNijenhuisVJDelewiR, et al. Aspirin with or without clopidogrel after transcatheter aortic-valve implantation. N Engl J Med. 2020;383:1447-1457. doi:10.1056/NEJMoa2017815
56.
BaumgartnerHFalkVBaxJJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739-2791. doi:10.1093/eurheartj/ehx391
57.
NishimuraRAOttoCMBonowRO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70:252-289. doi:10.1016/j.jacc.2017.03.011
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