Cardiac surgery's long opioid dependency: time to recalibrate pain therapy?

Br J Anaesth. 2022 Nov;129(5):655-658. doi: 10.1016/j.bja.2022.08.008. Epub 2022 Sep 15.


Opioid analgesia is the cornerstone of anaesthetic management during cardiac surgery. However, a subset of patients use opioids persistently after three months of surgery. We discuss a recent meta-analysis and systematic review by Liu and colleagues describing both patient and peri-procedural risk factors that contribute to this phenomenon in the context of chronic pain after cardiac surgery. Anaesthetists for cardiac surgery should consider opioid alternatives and individual patient risk factors to optimise recovery and pain control.

Keywords: cardiac surgery; chronic pain; multimodal analgesia; perioperative opioid use; persistent opioid use.

Publication types

  • Editorial
  • Comment

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Cardiac Surgical Procedures* / adverse effects
  • Humans
  • Meta-Analysis as Topic
  • Opioid-Related Disorders* / etiology
  • Pain Management* / adverse effects
  • Pain Management* / methods
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Systematic Reviews as Topic


  • Analgesics, Opioid