Background: Atrial fibrillation is one of the most frequent complications and a major risk of morbidity and mortality after cardiac surgery. Antioxidants such as vitamin C are used for prevention of this arrhythmia. Different results of studies have been reported, but most of them have shown efficiency of vitamin C in prophylaxis of postoperative AF. We tried to examine this efficacy with larger sample size. Methods: Three hundred and fourteen on pump coronary artery bypass graft surgery alone. Patients were divided into two groups: The intervention group received vitamin C (N = 160) and the control group did not receive any (N = 154). Intervention group was administered two grams of vitamin C intravenously (IV) 24 hours preoperatively, 500 mg every 12 hours IV for 48 hours in ICU, and 500 mg every 12 hours PO for 48 hours in ward. Continuous monitoring in ICU and three times a day ECG was used for AF detection. The two groups were compared. Results: The two groups were matched in terms of age, sex, LA size, ejection fraction, functional class, and TSH level. Of the patients, 244 were male. Mean age was 62 years (40-84 years) in both groups. M/F ratio was four in both groups. Functional class and ejection fraction were the same in both groups. There was no mean TSH level difference. AF occurrence in vitamin C group was 7.6 % and in control group was 7.8 %. There was no difference in ICU or hospital stay. Conclusions: Prophylactic use of vitamin C does not further reduce postoperative atrial fibrillation in on pump CABG patients.
Esophageal papilloma is a rare disorder that may cause hypopharyngeal symptoms. This patient was a 56‐year‐old man who presented with cough and choking symptoms. After the initial negative laryngoscopy, a fiberoptic endoscopy revealed a mass originating from the hypopharyngeal area, which was resected surgically and found to be non‐malignant.
Background:Postoperative bleeding is a common problem in cardiac surgery. We tried to evaluate the effect of topical tranexamic acid (TA) on reducing postoperative bleeding of patients undergoing on-pump coronary artery bypass graft (CABG) surgery.Materials and Methods:One hundred and twenty-six isolated primary CABG patients were included in this clinical trial. They were divided blindly into two groups; Group 1, patients receiving 1 g TA diluted in 100 ml normal saline poured into mediastinal cavity before closing the chest and Group 2, patients receiving 100 ml normal saline at the end of operation. First 24 and 48 h chest tube drainage, hemoglobin decrease and packed RBC transfusion needs were compared.Results:Both groups were the same in baseline characteristics including gender, age, body mass index, ejection fraction, clamp time, bypass time, and operation length. During the first 24 h postoperatively, mean chest tube drainage in intervention group was 567 ml compared to 564 ml in control group (P = 0.89). Mean total chest tube drainage was 780 ml in intervention group and 715 ml in control group (P = 0.27). There was no significant difference in both mean hemoglobin decrease (P = 0.26) and packed RBC transfusion (P = 0.7). Topical application of 1 g TA diluted in 100 ml normal saline does not reduce postoperative bleeding of isolated on-pump CABG surgery.Conclusion:We do not recommend topical usage of 1 g TA diluted in 100 ml normal saline for decreasing blood loss in on-pump CABG patients.
Background and aims: To investigate the effect of progressive muscle relaxation on sleep quality and postoperative pain in patients undergoing heart valve replacement surgery. Methods: In this quasi-experimental study, 60 patients undergoing surgery that enter were randomly divided into the muscle relaxation (n=30) or control group (n=30). Data were collected by Pittsburgh Sleep Quality Index and McGill Pain Questionnaire before and after the intervention. Patients in the control group received routine care, but patients in the muscle relaxation group performed a progressive relaxation technique twice a week for one month. Results: Most of the male participants in both groups had diplomas. There is no significant difference between the two groups of relaxation and control regarding age, gender, occupation, and education levels. The mean sleep quality score in the control group was not significantly reduced after the intervention. However, the mean sleep quality in the relaxation group before 13.90±2.23 and after the intervention was 8.03±2.01 significantly decreased (P<0.001). Also, the pain score was significantly reduced after the progressive relaxation group in the intervention group (P<0.001). Although the two groups were the same in all the dimensions of sleep quality before the intervention, significant differences were observed between groups after the intervention in all the dimensions. Conclusion: Progressive muscle relaxation has an influential role in the pain decrease and sleep quality of patients undergoing heart valve replacement surgery and can be used as a safe and cost-free method for patients.
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