Comparative Analysis of Analgesic Approaches in the Early Period After CABG

Prior treatment

• 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.

Other illness

• Failure to meet the inclusion criteria.
• 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).
• 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.
• 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.

Other

• Pregnancy or lactation.
• Liver cirrhosis, Child-Pugh class C.
• 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.
• 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.

• 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