The Impact of Perioperative Use of a Statin–Magnesium Combination on Opioid Consumption in Patients Who Underwent Cardiac Surgery: A Retrospective Study with Propensity-Score Matching

Both statins and magnesium are associated with NMDA receptors and anti-inflammatory effect. Peripheral NMDA receptors are known to be involved in inflammation-induced pain. This study aimed to investigate the impact of perioperative use of a statin-magnesium combination on opioid consumption in patients who underwent cardiac surgery. This was a retrospective study of 542 patients who underwent cardiac surgery. The patients were divided into two groups according to statin use: the statin-magnesium group (n=375) and the magnesium-only group (n=167). Patients in the magnesium-only group received only perioperative magnesium, but no statins, to prevent atrial fibrillation following cardiac surgery. After propensity-score matching, 228 patients (n=114 in each group) were analyzed to investigate opioid consumption, visual analogue scale (VAS) pain scores over a 72-h period, and pain outcomes according to the duration of statin treatment (<1 or ≥1 yr). The consumed opioid volume was significantly smaller in statin-magnesium group than the magnesium-only group, both before (p=0.010) and after matching (p=0.017). The statin-magnesium combination did not significantly reduce the VAS pain scores compared with magnesium alone. Although the statin-magnesium combination did not significantly reduce the pain intensity compared with magnesium alone, the combination therapy was effective in reducing opioid consumption after surgery.