91桃色

Abstract

Aim: To assess postoperative pain intensity and the analgesic requirements in the postoperative period, in patients undergoing sternotomy for pulmonary endarterectomy involving deep hypothermic circulatory arrest compared to valvular cardiac surgery not involving deep hypothermic circulatory arrest. Design & Setting: Retrospective cohort study, single-hospital center study. Participants: Patients 18 years and older undergoing sternotomy for cardiac surgery between August 2012 and August 2014 were considered for the study. Interventions: No modification to usual clinical practice. Measurements & Results: Intraoperative opioid and steroid administration, Intensive Care Unit pain scores and analgesic administration in the first 48 hours after the admission to the Unit were recorded. Postoperative pain was evaluated by means of a categorical verbal scale from no pain (0) to severe pain (3) as this is the routine analgesic scale used in our Intensive Care Unit. A total of 300 consecutive sternotomy patients were included: 200 undergoing pulmonary endarterectomy (PTE group) and a control group of 100 valvular cardiac surgical procedures (non-PTE group). No patient in the PTE group received morphine during surgery while all patients in non-PTE group did (p<0.001). Mean (standard deviation) post-operative pain intensity score at 24 hours was 0, 30 (0, 54) in PTE group and 0, 22 (0, 41) in non-PTE group (p=0.193). Postoperative morphine was administered in 39% patients in PTE-group and in 47% in non-PTE group 2 (p= 0.185). Conclusion: The total analgesic requirements of patients undergoing sternotomy for pulmonary endarterectomy was lower compared to patients undergoing conventional valvular cardiac surgery. No differences in pain score was found at 24 hours after surgery.

Biography

Email: marc.gimenez@nhs.net