Pain after sternotomy – review

Huang, Ana Paula Santana; Sakata, Rioko Kimiko

doi:10.1016/j.bjane.2014.09.013

Cited by 58 publications

(90 citation statements)

References 51 publications

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“…The causes of these reductions may be related to surgical manipulation, degree of sedation, cardioplegic agents, thermal damage, and cardiopulmonary bypass used that lead to change in pulmonary mechanics and respiratory compliance (3,(18)(19)(20)(21). Also, post-operative pain may cause of immobilizing and restrictive pulmonary pattern (22). However, the pain scales in this study showed no difference between admission and discharge periods.…”

Section: Discussioncontrasting

confidence: 63%

Alteration of Inspiratory Muscle Strength Is Related to Change in Deep Breathing Heart Rate Variability in Patients Submitted to Open-Heart Surgery

Pongpanit

Viseschoonhasilp

Ruangklai

et al. 2019

Chest

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Aim: Despite the reduction of respiratory muscle strength and cardiac autonomic modulation after open-heart surgery has been demonstrated, the association between changes in both variables has not been investigated. This study aimed to determine the correlation between change in inspiratory muscle strength and change in deep breathing heart rate variability in patients submitted to open-heart surgery. Material and Methods: An observational cross-sectional study was conducted among 32 participants aged between 35 and 60 years who were undergoing coronary artery bypass graft and cardiac valve surgery. Inspiratory muscle strength was assessed by measuring maximal inspiratory pressure using a respiratory pressure meter (RPM 01, Micro Medical Ltd., United Kingdom). Deep breathing heart rate variability was collected using a Polar heart rate monitor (Polar Electro Ltd., Finland) during a slow and deep breathing control. Evaluations were performed on the day of admission and discharge. Results: There was statistically significant reduction in maximal inspiratory pressure and deep breathing heart rate variability indices in discharge period (p<0.05). The difference of expiratory/inspiratory ratio and inspiratory-expiratory differences was significantly correlated with the change in maximal inspiratory pressure in both absolute (r=-0.864, p=0.003 and r=-0.841, p=0.004, respectively) and percentages of predicted values (r=-0.868, p=0.003 and r=-0.834, p=0.005, respectively). Conclusion: Inspiratory muscle weakness was related to impair cardiac vagal modulation in patients who had undergone open-heart surgery. The present study could provide rehabilitation targets to improve inspiratory muscle strength and cardiac vagal tone.

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Section: Discussioncontrasting

confidence: 63%

Alteration of Inspiratory Muscle Strength Is Related to Change in Deep Breathing Heart Rate Variability in Patients Submitted to Open-Heart Surgery

Pongpanit

Viseschoonhasilp

Ruangklai

et al. 2019

Chest

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“…43 Moreover, better control of acute pain after cardiac surgery has been shown to reduce cardiovascular morbidity, pneumonia, and hypercoagulability due to reductions in the stress response. [44][45][46] …”

Section: Acute Pain Severity and Treatmentmentioning

confidence: 99%

Chronic Poststernotomy Pain

Kleiman

Sanders

Nemergut

et al. 2017

Regional Anesthesia and Pain Medicine

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Chronic pain following median sternotomy is common after cardiac surgery. If left untreated, chronic sternal pain can reduce quality of life, affecting sleep, mood, activity level, and overall satisfaction. This has a significant societal effect given the large number of cardiac surgeries annually. Although a number of pathophysiologic processes and risk factors are assumed to contribute, the exact cause and major risk factors remain unknown. Moreover, the treatment of chronic poststernotomy pain is often inadequate, relying on opioids and other medications that provide minimal benefit to the patient and have significant adverse effects. Indeed, little is known regarding the prevention of chronic pain development following sternotomy. This review aims to present the current, limited data regarding the incidence, risk factors, treatment, and prevention of chronic poststernotomy pain and to identify areas of future research to improve management of this common complaint following cardiac surgery.

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“…Ağrı kontrolünde herhangi bir tekniğin üstünlüğü saptanamamıştır. Kombine multimodal analjezi ağrı yönetimini sağlayarak, komplikasyonlar ve yan etkiler azaltılabilir 65,66 .…”

Section: Ağrıunclassified

Current Nursing Approaches After Heart Valve Surgery: Why care is important?

Kankaya¹,

Bilik²

2018

BSBD

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Kalp kapak ameliyatları sonrası dönemde hemşirelik bakımı oldukça karmaşıktır. Bu ameliyatlar açık kalp cerrahisi tekniğiyle yapıldığından; ameliyatta hipotermi uygulanması, median sternotomi, mekanik protez kapak implantasyonu, göğüs tüpleri, akut dönemde yoğun bakımda mekanik ventilasyona bağlı kalınması odaklanılması gereken ve çeşitli güçlükler yaratan konulardan sadece bir kaçıdır. Bu alandaki rehberler genellikle tedavi ilkeleri üzerine yoğunlaşmakta olup, kalp kapak ameliyatı olan hasta grubunun bakımını tümüyle içeren bir rehbere ulaşılamamıştır. Açık kalp ameliyatı yöntemiyle kalp kapak ameliyatı uygulanan hastanın bakımına yönelik ülkemizdeki yayın sayısının yetersiz olması, bu derlemenin yazılış amacını oluşturmuştur. Kalp kapak hastalıkları dünyada ve ülkemizde oldukça sık görülmektedir. Bu ameliyatlar hastaların yaşam sürelerini uzatmak ve yaşam kalitelerini artırmak için yapılsa da, çeşitli komplikasyonlara ve istenmeyen durumlara neden olabildikleri için ameliyat sonrası dönemde yakın izlem ve yoğun hemşirelik bakımı gerektirmektedir. Kalp kapak ameliyatları hastaların tüm sistemlerini etkilediğinden, ameliyat öncesi hazırlıktan ameliyat sonrası bakıma kadar olan tüm süreçte hastanın yakından izlenmesi, komplikasyonların erken saptanması ve yönetilmesi açısından önemlidir. Kalp damar cerrahisi hemşireleri, bu özel hasta grubunun bakımında klinik bilgi ve becerilerinin yanı sıra eğitici rollerini aktif bir şekilde kullanabilirler.

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Pain after sternotomy – review

Cited by 58 publications

References 51 publications

Alteration of Inspiratory Muscle Strength Is Related to Change in Deep Breathing Heart Rate Variability in Patients Submitted to Open-Heart Surgery

Alteration of Inspiratory Muscle Strength Is Related to Change in Deep Breathing Heart Rate Variability in Patients Submitted to Open-Heart Surgery

Chronic Poststernotomy Pain

Current Nursing Approaches After Heart Valve Surgery: Why care is important?

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