scholarly journals Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Aik Bouzia ◽  
Vassilios Tassoudis ◽  
Menelaos Karanikolas ◽  
George Vretzakis ◽  
Argyro Petsiti ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cardiac Surgery ◽  
Sleep Disturbances ◽  
Median Sternotomy ◽  
Double Blind Study ◽  
Double Blind ◽  
Elective Cardiac Surgery ◽  
Group 2 ◽  
Postoperative Morphine ◽  
Group 1

Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75 mg, and Group 3 received oral pregabalin 150 mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively. Results. Patients receiving pregabalin required fewer morphine boluses (10 in controls versus 6 in Group 1 versus 4 in Group 2, p=0.000) and had lower pain scores at 8 hours (4 versus 3 versus 3, p=0.001) and 3 months (3 versus 2 versus 2, p=0.000) and lower morphine consumption at 8 hours (14 versus 13 versus 12 mg, p=0.000) and 24 hours (19.5 versus 16 versus 15 mg, p=0.000). Percentage of patients with sleep disturbances or requiring analgesics was lower in the pregabalin group and even lower with higher pregabalin dose (16/31 versus 5/31 versus 3/31, p=0.000, and 26/31 versus 16/31 versus 10/31, p=0.000, resp.) 3 months after surgery. Conclusion. Preoperative oral pregabalin 75 or 150 mg reduces postoperative morphine requirements and acute and chronic pain after cardiac surgery.

Adding herbal extracts to silicone gel on post-sternotomy scar: a prospective randomised double-blind study

2020 ◽  
Vol 29 (Sup4) ◽  
pp. S36-S42
Author(s):  
Palakorn Surakunprapha ◽  
Kengkart Winaikosol ◽  
Bowornsilp Chowchuen ◽  
Kriangsak Jenwitheesuk ◽  
Kamonwan Jenwitheesuk
Keyword(s):  
Aloe Vera ◽  
Median Sternotomy ◽  
Centella Asiatica ◽  
Herbal Extract ◽  
Double Blind Study ◽  
Herbal Extracts ◽  
Double Blind ◽  
Silicone Gel ◽  
Group 2 ◽  
Group 1

Objective: Silicone gel has been shown effective in improving healing post-sternotomy scars. It remains to be determined whether adding herbal extracts to the gel would augment the healing effect. Method: After median sternotomy, patients were randomised into two groups. Group 1: topical silicone gel plus herbal extract gel (Allium cepa, Centella Asiatica, Aloe vera and Paper Mulberry) and Group 2: silicone gel. Patients were treated for six months. The postoperative scars were assessed at three and six months by plastic surgeons using the Vancouver Scar Scale (VSS) and the patient assessment scar scale. Results: Each group comprised 23 patients (n=46 in total). The VSS was significantly lower in Group 1 than in Group 2 (p=0.018 and p=0.051, respectively). In Group 1, the four differences from baseline were vascularity scores at three and six months (–0.391, p=0.025; –0.435, p=0.013, respectively), and pigmentation scores at three and six months (–0.391, p=0.019; –0.609, p=0.000, respectively). In Group 2, differences from baseline were the pigmentation and vascularity score at six months (–0.6609, p=0.000; –0.348, p=0.046, respectively). Conclusion: Our results suggest, post-sternotomy scars trend to have better vascularity and pigmentation when treated with silicone gel plus herbal extracts.

Bilateral ultrasound-guided thoracic erector spinae plane blocks using a programmed intermittent bolus improve opioid-sparing postoperative analgesia in pediatric patients after open cardiac surgery: a randomized, double-blind, placebo-controlled trial

2020 ◽  
Vol 45 (10) ◽  
pp. 805-812
Author(s):  
Philippe Macaire ◽  
Nga Ho ◽  
Vien Nguyen ◽  
Hieu Phan Van ◽  
Kim Dinh Nguyen Thien ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Intermittent Bolus ◽  
Drain Removal ◽  
Group 2 ◽  
Postoperative Morphine ◽  
Group 1

BackgroundPostoperative pain after pediatric cardiac surgery is usually treated with intravenous opioids. Recently, the focus has been on postoperative regional analgesia with the introduction of ultrasound-guided erector spinae plane blocks (ESPBs). We hypothesized that bilateral ESPB with a programmed intermittent bolus (PIB) regimen decreases postoperative morphine consumption at 48 hours and improves analgesia in children who undergo cardiac surgery.MethodsThis randomized, double-blind, placebo-controlled study comprised 50 children who underwent cardiac surgery through midline sternotomy. The patients were allocated randomly into two groups: ultrasound-guided bilateral ESPB at the level of T3–T4 transverse process then PIB with saline infusion (group 1, n=23) or PIB with 0.2% ropivacaine (group 2, n=27). Intravenous morphine at 30 µg/kg/hour was used as rescue analgesia. Postoperative pain was assessed using the COMFORT-B score for extubation, drain removal, and mobilization, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale at 0, 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 hours after surgery. Adverse events were noted.ResultsThe total dose of morphine in 48 hours was significantly decreased in patients receiving a bilateral ESPB with ropivacaine (120±320 µg/kg) compared with patients with saline infusion (512±560 µg/kg; p=0.03). Fourteen per cent of patients required rescue analgesia with morphine in group 2 compared with 41% in group 1 (p=0.05). The patients in group 2 demonstrated significantly reduced COMFORT-B scores at extubation, drain removal, and mobilization compared with those in group 1 and had reduced FLACC scale levels at 20 and 24 hours postoperatively (p=0.05 and p=0.001, respectively). No differences were reported for extubation and drain removal times or for length of hospital stay. In addition, vomiting episodes were decreased in group 2 (p=0.01).ConclusionsIn pediatric cardiac surgery, the results of this study confirm our hypothesis that bilateral ESPB analgesia with ropivacaine decreases the postoperative morphine consumption at 48 hours and demonstrates better postoperative analgesia compared with a control group.Trial registration numberNCT03593642.

Cephradine and cefazolin plasma levels during cardiac surgery

Perfusion ◽  
1986 ◽  
Vol 1 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Sergio V Moran ◽  
Francisco Montiel ◽  
Guillermo Acuña ◽  
Jeanette Vergara ◽  
Manuel J Irarrazaval ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Plasma Levels ◽  
Early Postoperative Period ◽  
Good Choice ◽  
Double Blind Study ◽  
Double Blind ◽  
Postoperative Course ◽  
Group 2 ◽  
Group 1

A prospective, randomized, double-blind study was carried out to evaluate two prophylactic regimes in patients undergoing cardiac surgery with cardiopulmonary bypass. Antibiotic plasma levels were measured in fifty consecutive adult patients undergoing valve and coronary surgery. They were divided into two comparable groups of 25 patients, each matched in age, sex, type of operation and duration of cardiopulmonary bypass. Group 1 received 1 g of cephradine with the anaesthetic premedication, 1 g in the prime of the oxygenator and 1 g every six hours during the first 72 hours of the postoperative course. Group 2 received cefazolin following the same protocol except that they received 1 g every eight hours during the postoperative course. There were no allergic or toxic reactions and no infections up to two months follow-up in both groups. Antibiotic plasma levels were significantly higher (p < 0·001) in the cefazolin group in four out of five sampling periods. Antibiotic plasma levels for group 1 versus group 2 were as follows: initial level 11·7 ± 5.2 mcg/ml vs 31 4 ± 35·4 mcg/ml. During cardiopulmonary bypass 26·6 ± 9·5 mcg/ml vs 51·7 ± 21 ·1 mcg/ml. Final levels 13·6 ± 7·0 mcg/ml vs 32·2 ± 17·8 mcg/ml. Baseline levels 2·7 ± 2·3 mcg/ml vs 6·· ± 7·7 mcg/ml and peak level 44·0 ± 16·2 mcg/ml vs 51·2 ± 23·4 mcg/ml (NS). The results of this study demonstrate that cefazolin achieved significantly higher plasma levels during the different phases of the operation and early postoperative period. Also, cefazolin and cephradine levels are above the minimal inhibitory concentrations for the gram positive and gram negative susceptible bacteria, except for the basal levels obtained by cephradine. The favourable pharmacokinetic characteristics of cefazolin, makes it a good choice for prophylactic use during cardiac surgery.

Comparison of Rosuvastatin versus Atorvastatin for Preventing Postoperative Atrial Fibrillation

2013 ◽  
Vol 16 (3) ◽  
pp. 158 ◽  
Author(s):  
Okay Abaci ◽  
Cuneyt Kocas ◽  
Veysel Oktay ◽  
Cenk Eray Yildiz ◽  
Kadriye Orta Kilickesmez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Left Ventricular ◽  
Postoperative Atrial Fibrillation ◽  
Atorvastatin Treatment ◽  
Elective Cardiac Surgery ◽  
Increased Risk ◽  
History Of ◽  
Group 2 ◽  
Group 1

<p><b>Background:</b> Postoperative atrial fibrillation (AF) following cardiac surgery is associated with an increased risk of stroke, prolonged hospitalization, and increased costs. Statin therapy is associated with a lower incidence of postoperative AF. We aimed to compare the preventive effects of rosuvastatin and atorvastatin on postoperative AF.</p><p><b>Methods:</b> This study included 168 patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients were divided into 2 groups according to treatment of statin. Group 1 (n = 96) was patients receiving atorvastatin, and group 2 (n = 72) was patients receiving rosuvastatin. Postoperative electrocardiographs (ECGs) and telemetry strips were examined for AF within postoperative period during hospitalization.</p><p><b>Results:</b> The incidences of postoperative AF were 17.9% (n = 17) in group 1 and 22.2% (n = 16) in group 2 (<i>P</i> = .48). Left ventricular end-diastolic diameter (LVEDD) and ejection fraction (EF) were not different between groups. Incidence of diabetes, hypertension, hyperlipidemia, smoking, myocardial infarction in past medical history, family history of atherosclerosis, male sex, drug use, and perioperative features were similar between groups.</p><p><b>Conclusions:</b> The present study revealed that preoperative rosuvastatin or atorvastatin treatment did not have a different effect in preventing postoperative AF.</p>

scholarly journals Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

2019 ◽  
Author(s):  
Vinicius Barros Duarte de Morais ◽  
Rioko Kimiko Sakata ◽  
Ana Paula Santana Huang ◽  
Leonardo Henrique da Cunha Ferraro
Keyword(s):  
Side Effects ◽  
Pain Intensity ◽  
Analgesic Effect ◽  
Multimodal Analgesia ◽  
Controlled Study ◽  
Physical Status ◽  
Double Blind ◽  
Group 2 ◽  
Postoperative Morphine ◽  
Group 1

Abstract Background Patients undergoing bariatric surgery can have respiratory complications in addition to vomiting and ileus. Esmolol can decrease the consumption of opioids, reducing their side effects. The purpose of this study was to evaluate the analgesic effect of esmolol in patients allocated to laparoscopic gastroplasty. Methods Forty patients between 18 and 50 years old, of both genders, physical status ASA I-II, who underwent bypass gastroplasty were divided into two groups. Participants in group 1 received a 0.5 mg/kg bolus of esmolol in 30 mL of saline before induction of anesthesia, followed by infusion of 15µg/kg/min until the end of surgery; those in group 2 received 30 mL of saline bolus and infusion of solution in the same volume as group 1. The anesthesia included fentanyl (5ug/kg), propofol (2-4 mg/kg), rocuronium (0.6 mg/kg), 50% oxygen without nitrous oxide and 2% sevoflurane, with remifentanil if necessary. There were evaluated: remifentanil consumption, time to analgesic supplementation, pain intensity for 24 h and morphine dose over 24 h. Side effects were noted. Results Intraoperative remifentanil supplementation, time to recovery, and postoperative morphine supplementation were lower in the esmolol group; there was no difference in time for the first supplementation. Pain intensity was lower, except at T0 and after 12 h. There were no differences in side effects. Conclusions Intraoperative esmolol promotes an analgesic effect without causing adverse effects, making it an effective drug for multimodal analgesia for gastroplasty.

scholarly journals Effect of intravenous magnesium sulphate on hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy: A prospective, double blind study

2019 ◽  
Author(s):  
Karishma Bansal ◽  
Maharishi Markandeshwar ◽  
Utkarsh Garg ◽  
Kritesh Goel ◽  
Divya Vijay ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Magnesium Sulphate ◽  
Hemodynamic Response ◽  
Blind Study ◽  
P Value ◽  
Double Blind Study ◽  
Double Blind ◽  
Intravenous Magnesium ◽  
Group 2 ◽  
Group 1

Background and Aim: Pneumoperitoneum (PP) for laparoscopic surgery is known to induce a pressor response. It can be attenuated by drugs, like opioids, vasodilators, beta blocking agents and alpha-2 agonists, but these drugs have their side effects. This study investigated the efficacy of magnesium sulphate to attenuate hemodynamic response associated with pneumoperitoneum in patients undergoing laparoscopic cholecystectomy.Methodology: This randomized, double blind, prospective study was carried out at Department of Anesthesiology, Maharishi Markandeshwar University, Mullana, Haryana (India). A total of 60 patients of ASA grade I or II, aged 20-60 y, of either sex, undergoing laparoscopic cholecystectomy, were randomly allocated into one of the two groups of 30 each. Standardized general anesthesia was administered to all patients. Group 1 patients received magnesium sulphate (30 mg/kg) intravenously as a bolus before induction of PP and Group 2 patients received same volume of 0.9% normal saline. Hemodynamic variables, e.g. heart rate (HR), systolic (SBP), diastolic (DBP), mean arterial pressures (MAP) were recorded from the start of surgery till extubation. Statistical analysis: SPSS version 17.0 for windows was used and p value of < 0.05 was considered significant.Results: Mean HR was 81.50 ± 8.44 vs. 93.03 ± 6.93/min, SBP was 126.37 ± 13.03 vs. 150.20 ± 10.45 mmHg, DBP was 82.50 ± 11.20 vs. 94.73 ± 8.33 mmHg, and MAP 98.43 ± 10.29 vs.113.27 ± 9.16 mmHg in Group 1 and Group 2, respectively, at 10 min after PP. Statistically significant fall in HR, SBP, DBP, MAP was seen in Group 1 at 10 min after PP till extubation. (p < 0.05).Conclusion: Intravenous magnesium sulphate effectively attenuates the hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy under general anesthesia.Citation: Bansal K, Santpur MU, Garg U, Goel K, Vijay D, Tatineni Bansal. Effect of intravenous magnesium sulphate on hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy: A prospective, double blind study. Anaesth pain & intensive care 2019;23(3):290-294

scholarly journals The Effect of Preoperative Oral Chlorhexidine Rinse on Ventilator Associated Pneumonia and ICU Mortality After Open Heart Surgery

2021 ◽  
Author(s):  
İbrahim Uğur ◽  
Nurgül Yurtseven ◽  
Senem Polat ◽  
Sibel Yılmaz Ferhatoğlu ◽  
Seyda Ocalmaz
Keyword(s):  
Cardiac Surgery ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Computer Software ◽  
Ventilator Associated Pneumonia ◽  
Elective Cardiac Surgery ◽  
Group 2 ◽  
Software Group ◽  
Group 1

Objective: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU). VAP develops 10-20% of patients in 48 hours of mechanical ventilation. In this study, it was aimed to determine the effect of preoperative oral chlorhexidine rinse on VAP and mortality in patients undergoing open cardiac surgery. Methods: 300 patients who were planned to undergo elective open cardiac surgery were included in this study. Patients were prospectively randomized into two groups by a computer software. Group 1: Patients brushing their teeth and then gargling with 0.12% chlorhexidine before bedtime at the last night before surgery and 15 minutes before going to the operating room. Group 2, It consisted of patients only brushing their teeth. Results: VAP was seen in 3 patients (2.12%) in Group 1 and in 12 (8.10%) patients in Group 2 (p<0.02). Duration of intubation was 15±7.40 hours for Group 1 and 23 32.01 for Group 2. These differences were statistically significant (p <0.01). Although duration of ICU stay and hospital stay in Group 1 are shorter than in Group 2 but it was not statistically significant (p>0.05). There was no difference in mortality (p>0.05). Conclusion: Consequently, chlorhexidine gluconate rinse before elective cardiac surgery reduced the VAP rate and duration of intubation but did not change the mortality rate and the length of ICU and hospital stay. On the other hand we think these results would be change in large multicentric studies.

scholarly journals Multinodular goitre surgery complications and directly observed surgeons’ skills: a prospective double-blind observational cohort study

2021 ◽  
Author(s):  
Hafiz Naweed Ahmad ◽  
Fayyaz Ahmad ◽  
Admin
Keyword(s):  
Surgical Technique ◽  
Direct Observation ◽  
Real Life ◽  
University Hospital ◽  
Double Blind Study ◽  
Multinodular Goitre ◽  
Double Blind ◽  
Group 2 ◽  
The One ◽  
Group 1

Objective: To study multinodular goitre patients’ surgery by direct observation of surgical technique, and to compare complications with surgeons’ skills and experience, for improved training of future thyroid surgeons. Methods: Based on positivist epistemology and analytical observational design, this prospective double-blind study of a cohort of multinodular goitre patients operated upon by variedly experienced surgeons, was conducted at Bahawal Victoria Hospital Bahawalpur and Nishtar Medical University Hospital Multan, Pakistan, from December 2016 to April 2019. Patients were admitted through outpatient department and operated upon in routine operation lists. The surgeons were specialists/senior registrars, assistant professors, associate professors and professors. The patients were divided into two virtual groups: the one operated upon by surgeons with >3 years of post-fellowship experience and the other operated upon by surgeons with <3 years of post-fellowship experience. Surgeries were directly observed and differences in surgical technique and complications were recorded for respective groups. Data was analysed using SPSS 20. Results: Of the 134 patients, there were 73(54.5%) in group 1 and 61(45.5%) in group 2. Overall, there were 119(88.8%) females and 15(11.2%) males. The overall mean age was 37.17+/-13.41 years (range: 14-80 years). Of the 25 surgeons, 13(52%) were in group 1 and 12(48%) in group 2. Group 1 had fewer complications compared to group 2, which on certain parameters was statistically significant (p<0.05). Conclusion: Surgeons’ experience and technique were found to have significant relationship with the rate of complications. Direct observation of surgeries is significant for real life evaluation and training of junior surgeons.

scholarly journals Effectiveness of Traditional Japanese Herbal (Kampo) Medicine, Daiobotanpito, in Combination with Antibiotic Therapy in the Treatment of Acute Diverticulitis: A Preliminary Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Keiko Ogawa ◽  
Koji Nishijima ◽  
Fumio Futagami ◽  
Takashi Nakamura ◽  
Genichi Nishimura
Keyword(s):  
Acute Diverticulitis ◽  
Statistical Significance ◽  
Kampo Medicine ◽  
Double Blind Study ◽  
Open Label ◽  
Double Blind ◽  
Patient Demographics ◽  
Intravenous Antibiotics ◽  
Group 2 ◽  
Group 1

In traditional Japanese herbal (Kampo) medicine, daiobotanpito (DBT) or Da Huang Mu Dan Tang in Chinese has been used in medical treatment of acute diverticulitis for many years based on the experience. Our aim was to investigate whether the treatment of acute diverticulitis can be treated with intravenous antibiotics plus orally administrated DBT than intravenous antibiotics alone. A retrospective nonrandomized open-label trial was established to compare patients with acute diverticulitis who received oral DBT associated with intravenous antibiotics with those who received intravenous antibiotic alone. We included 34 patients, eleven patients in group 1 with DBT and 23 patients in group 2 without DBT. Both groups were comparable in patient demographics and clinical characteristics. There was a significantly better outcome in the group treated with DBT than in the group without DBT when comparing duration of fever, abdominal pain, and antibiotics administration. A trend toward a day shorter mean hospital stay and fasting was seen in group 1, although this did not reach statistical significance. In conclusion, most patients with acute diverticulitis can be managed safely with oral DBT. Although randomized, double-blind study must be done, we could show the possibility to use daiobotanpito as an additional option in treating acute diverticulitis.

scholarly journals A comparison of three different gauge Quincke’s spinal needles in patients undergoing elective surgery under spinal anaesthesia: a prospective randomized study

2019 ◽  
Vol 7 (11) ◽  
pp. 4188
Author(s):  
Kiranpreet Kaur ◽  
Suresh K. Singhal ◽  
Anu Mehla
Keyword(s):  
Success Rate ◽  
Spinal Anaesthesia ◽  
Elective Surgery ◽  
Randomized Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Male Patients ◽  
Group 2 ◽  
Traumatic Effect ◽  
Group 1

Background: The present study was conducted to compare three different Quincke’s spinal needles i.e. 23, 25 and 26 gauge in patients undergoing elective surgery under spinal anaesthesia (SA).Methods: The prospective randomized double-blind study was conducted on 150 male patients in the age group of 18-50 yrs., having physical status class I to II, scheduled for elective surgery under SA. Patients were randomly divided into three groups comprising 50 patients each. SA was administered using Quincke’s spinal needles of 23, 25 and 26 gauge in group 1, 2 and 3 respectively. Ease of insertion, number of attempts and time of appearance of CSF and incidence of PDPH was recorded in all the patients.Results: Ease of insertion was graded easy in 98%, 84% and 82% in group 1, 2 and 3 respectively. First attempt success rate was highest in group 1, (98%). Meantime for appearance of CSF beyond hub was maximum in group 3 i.e. 14.60±2.56 sec. Mild PDPH was reported in 6% and 2% patients after 24 hrs in group 1 and group 2 respectively.Conclusions: Finer spinal needle proved to be more dependable in generating less traumatic effect on the dura and preventing PDPH but are technically more difficult thus decreasing first attempt success rate.

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