Comparative Analysis of Analgesic Approaches in the Early Period After CABG

Inclusion Criteria

• •ASA score less then 3, Signed inform consent, Absence of preoperative drugs administration that affects patient's perception of pain, No active infection process, BMI index \>18,5 kg\\m2 and \< 35 kg/m2, CABG, Age 18-75 years
• •High severity according to ASA (class IV or higher), which is associated with a high probability of prolonged mechanical ventilation, hemodynamic instability, and inability to use drugs affecting cardiac output and/or total peripheral vascular resistance.
• •Contraindications to the use of tafalgin and/or morphine in accordance with the approved Summary of Product Characteristics (hypersensitivity to tafalgin, morphine, other opioids, or any excipients).
• •Pregnancy or lactation.
• •Acute or prolonged chronic intoxication with drugs or substances depressing the central nervous system (alcohol, barbiturates, opioid drugs, benzodiazepines).
• •Use of monoamine oxidase inhibitors (MAOIs) or less than 14 days since their discontinuation.
• •Liver cirrhosis, Child-Pugh class C.
• •Acute renal failure requiring renal replacement therapy.
• •Unresected malignant neoplasm.
• •Mesenteric thrombosis or another severe abdominal pain syndrome of unclear etiology at the time of inclusion.
• •Simultaneous participation in another clinical study.
• •Marked CNS depression due to any cause, except for acute poisoning.
• •COPD stage III and/or bronchial asthma in the exacerbation phase.
• •Any clinically significant condition, disease, or circumstance in the medical history that, in the opinion of the investigator, precludes participation in the study.
• •Psychiatric, physical, or other conditions preventing adequate assessment of the patient's behavior or proper compliance with the study protocol.
• •Postoperative hemodynamic instability requiring high-dose inotropic and/or vasopressor support (epinephrine \> 0.1 μg/kg/min, dopamine \> 10 μg/kg/min, norepinephrine \> 0.2 μg/kg/min) and/or mechanical circulatory support.
• •Refusal to participate in the study.