Correspondence  |   August 2016
Steroids Do Not Reduce Persistent Pain after Cardiac Surgery: Should This Be the End of the Question or the Beginning of Newer Questions?
Author Notes
  • St Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada (H.S.). harshamd@gmail.com
  • This letter was sent to the author of the original article referenced above, who declined to respond—Evan D. Kharasch, M.D., Ph.D., Editor-in-Chief.
    This letter was sent to the author of the original article referenced above, who declined to respond—Evan D. Kharasch, M.D., Ph.D., Editor-in-Chief.×
  • (Accepted for publication March 30, 2016.)
    (Accepted for publication March 30, 2016.)×
Article Information
Correspondence
Correspondence   |   August 2016
Steroids Do Not Reduce Persistent Pain after Cardiac Surgery: Should This Be the End of the Question or the Beginning of Newer Questions?
Anesthesiology 8 2016, Vol.125, 423-425. doi:10.1097/ALN.0000000000001183
Anesthesiology 8 2016, Vol.125, 423-425. doi:10.1097/ALN.0000000000001183
We read with interest the study by Turan et al.1  on the use of methylprednisolone for persistent incisional pain after cardiac surgery. This substudy was done on 1,110 of the 7,500 patients included for the Steroid In caRdiac Surgery (SIRS) trial.2  The treatment group received 500 mg methylprednisolone (given as 250 mg doses at induction and cardiopulmonary bypass), and the placebo group received comparable placebo. The study failed to show any difference in the incidence of persistent incisional pain, measured as 0 to 10 numerical rating scale, both at 6 months (primary) and 30 days (secondary). Considering that this is the largest study ever published on the use of steroids for reducing persistent postsurgical pain (PPSP), it could be interpreted as an argument against the use of steroids in PPSP for future studies. However, we would like to highlight some important considerations with regard to this argument and say that this should probably lead to newer questions and hypothesis on the future use of steroids, rather than making it a death knell on the use of steroids for PPSP.
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