Postoperative Pain Management in Adult Cardiac Surgery

Dabbagh, Ali

doi:10.1007/978-3-319-75747-6_17

Cited by 3 publications

(8 citation statements)

References 185 publications

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“…18,19 However, postoperative pain continues to be a significant source of morbidity with MICS, and there is empirical evidence that pain is an important variable impacting patient short-term and long-term recovery from cardiac surgeries. 1,3,5 Regarding postoperative LOS, there are clearly many factors contributing to this outcome. At our institution, the surgeon is not involved in discharge planning, as established clinical pathways are used to guide patient discharges, with the final decision being made by a nurse practitioner or a family physician working on the recovery ward.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Inadequate pain management at this time can lead to chronic postoperative pain, which may severely impact the patient's physiological functions and quality of life. 2,3,5 Minimally invasive cardiac surgeries (MICS) have increasingly gained attention in clinical practice for their potentially faster recovery in line with the Enhanced Recovery After Surgery (ERAS) paradigm shift in surgical care. MICS through right minithoracotomies are currently performed for…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac surgery patients often face acute postoperative pain from surgical incisions of tissues and arteries, irritation of the pleura, intercostal nerve disruptions, and more. [1][2][3][4][5] Inadequate pain management at this time can lead to chronic postoperative pain, which may severely impact the patient's physiological functions and quality of life. 2,3,5 Minimally invasive cardiac surgeries (MICS) have increasingly gained attention in clinical practice for their potentially faster recovery in line with the Enhanced Recovery After Surgery (ERAS) paradigm shift in surgical care.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 1 – 5 Inadequate pain management at this time can lead to chronic postoperative pain, which may severely impact the patient’s physiological functions and quality of life. 2 , 3 , 5 …”

Section: Introductionmentioning

confidence: 99%

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Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery

Hsieh,

Kim,

Peng

et al. 2023

Innovations�(Phila)

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Objective: Severe postoperative pain has been shown to affect many patients following minimally invasive cardiac surgeries (MICS). Multimodal pain management with regional anesthesia, particularly by delivery of local anesthetics using a paravertebral catheter (PVC), has been shown to reduce pain in operations involving thoracotomy incisions. However, few studies have reported high-quality safety and efficacy outcomes of PVCs following MICS. Methods: Patients who underwent MICS at Vancouver General Hospital between 2016 and 2019 ( N = 123) were reviewed for perioperative opioid-narcotic use. Primary outcomes were postoperative opioid use and hospital length of stay (LOS). Statistical analyses were performed using univariate and multivariable regression models to determine independent risk factors. Results: A total of 54 patients received routine systemic analgesia (control), 53 patients received a paravertebral catheter (PVC), and 16 patients received another mode of regional analgesia (non-PVC). The mean hospital LOS was significantly different in patients in the PVC group at 5.8 ± 2.0 days versus 8.3 ± 7.1 days in the control and 6.6 ± 2.3 days in the non-PVC group ( P = 0.033). The percentage of patients who did not require postoperative oxycodone was significantly higher in the PVC group (48.1%), compared with the control (24.5%) and non-PVC (37.5%; P = 0.043) groups. Conclusions: The administration of regional anesthesia using PVCs was associated with reduced need for opioids and a shorter LOS. The reduction in postoperative opioids may reduce the risk of potential opioid dependency in this population. Future studies should involve randomized controlled trials with systematic evaluation of pain scores to verify current study results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 1 – 5 Inadequate pain management at this time can lead to chronic postoperative pain, which may severely impact the patient’s physiological functions and quality of life. 2 , 3 , 5 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery

Hsieh,

Kim,

Peng

et al. 2023

Innovations�(Phila)

View full text Add to dashboard Cite

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Pain and sleep after open-heart surgery-inhalation peppermint essence: double-blind randomized clinical trial

Maghami

Pour‐Abbasi

Yadollahi

et al. 2023

BMJ Support Palliat Care

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ObjectiveThe aim of this study was to determine the effect of inhaling peppermint essence on pain relief and sleep quality after open-heart surgery.MethodsIn a double-blind randomised clinical trial carried out in Iran in 2020, 64 cardiac patients were selected by convenience sampling and randomly allocated to aromatherapy (n=32) and placebo (n=32) groups. The aromatherapy and control groups received inhaled aromatherapy using peppermint essence and distilled water, respectively. Data gathering tools were the Numeric Pain Rating Scale and St Mary’s Hospital Sleep Questionnaire. Data were analysed using an independent t-test, χ2test, Mann–Whitney U test and generalised estimating equation analysis.ResultsThe mean severity of pain in the aromatherapy and placebo groups was 3.22±0.88 and 4.56±0.90, respectively, which was a statistically significant difference (p=0.0001). The mean sleep scores after the intervention on day 1 were 20.10±4.90 and 25.76±6.36 in the aromatherapy and placebo groups, respectively, and 18.63±5.56 and 22.62±5.69, respectively, on day 2. The difference between the two groups was statistically significantly different after the intervention in terms of sleep quality (p<0.05).ConclusionAromatherapy attenuated pain and improved sleep quality after open-heart surgery. Peppermint essence aromatherapy is therefore recommended after surgery.

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Expression and Significance of KIM-1, NGAL, and HO-1 in Patients with Acute Kidney Injury After Cardiac Valve Replacement

Zhang¹,

Song²,

Ma³

et al. 2023

JIR

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Objective To investigate the changes and significance of perioperative expression levels of kidney injury molecule-1 (KIM-1), neutrophil gelatinase-related lipocalin (NGAL), and heme oxygenase-1 (HO-1) in patients with acute kidney injury (AKI) after cardiac valve replacement under cardiopulmonary bypass. Methods A total of 80 patients were divided into the AKI group and non-AKI group based on the postoperative occurrence of AKI. The expression levels of urinary KIM-1, NGAL, serum creatinine, urea nitrogen, and HO-1 were compared between the two groups before surgery and at 12 h, 24 h, and 48 h after surgery. Results There were 22 patients with postoperative AKI (AKI group), the incidence of postoperative AKI were 27.5%, and there were 58 patients without AKI (non-AKI group). There was no significant difference in general clinical data between the two groups ( P > 0.05). Compared between AKI group and preoperative group, KIM-1, NGAL, HO-1, blood creatinine, and BUN levels were significantly increased, with significant differences ( P < 0.05). Compared with non-AKI groups, KIM-1, NGAL, HO-1, blood creatinine, and blood urea nitrogen levels increased at all time points, but the difference was not significant ( P > 0.05). Compared with AKI group and non-AKI group, KIM-1, NGAL, HO-1, blood creatinine, and BUN levels increased significantly, the differences were statistically significant ( P < 0.05). Conclusion AKI can easily occur after cardiac valve replacement and postoperative expression levels of KIM-1, NGAL, and HO-1 can be early warning indicators of postoperative AKI.

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Postoperative Pain Management in Adult Cardiac Surgery

Cited by 3 publications

References 185 publications

Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery

Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery

Pain and sleep after open-heart surgery-inhalation peppermint essence: double-blind randomized clinical trial

Expression and Significance of KIM-1, NGAL, and HO-1 in Patients with Acute Kidney Injury After Cardiac Valve Replacement

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