Significant increases in Sao2 and PEFR occur after ICNB with 0.5% bupivacaine, which also provides sustained analgesia, leading to improvement in respiratory mechanics.
The risk factors that we studied were those identified at our institution at the particular period of time and also those culled from the existing literature.The risk factors were also found to vary from center to center and from time to time. Thus, not all studies reported that diabetes mellitus was a significant independent risk factors for sternal wound infection.
1-5The question of hyperglycaemia or uncontrolled diabetes mellitus as a significant risk factor needs further detailed examination because it is known that uncontrolled diabetes mellitus and hyperglycaemia will lead to an increase in overall infection rate and reduction of the immune response mechanism to infection. Rassias et al.,6 showed that insulin infusion improved neutrophil function in diabetic patients undergoing cardiac surgery.In our view, the determinant of diabetes mellitus as a risk factor for postcardiac surgery wound infection does not depend on the presence of diabetes mellitus per se but on the degree to which it has been controlled.
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