Comportamento da dor e da função pulmonar em pacientes submetidos à cirurgia cardíaca via esternotomia

Baumgarten, Maria; Garcia, Gisele Kalata; Frantzeski, Michele Hagi; Giacomazzi, Cristiane Mecca; Lagni, Verlaine Balzan; Dias, Alexandre Simões; Monteiro, Mariane Borba

doi:10.1590/s0102-76382009000500011

Cited by 34 publications

(16 citation statements)

References 21 publications

(27 reference statements)

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“…There were lower levels of pain from the median sternotomy on the second postoperative day than presented in previous studies [1, 27, 28]. During rest the patients had a median value of less than 1 on NRS, that is, almost no pain and during mobilisation a median value of 3.8 on NRS.…”

Section: Discussionmentioning

confidence: 45%

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Lung Function before and Two Days after Open-Heart Surgery

Urell

Westerdahl

Hedenström

et al. 2012

Critical Care Research and Practice

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Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairment has been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n = 107, 68 yrs, 80% male) performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale) and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI >25 had lower postoperative inspiratory capacity (IC) (33 ± 14% pred.) than normal-weight patients (39 ± 15% pred.), (P = 0.04). More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r = 0.33, P = 0.001; FEV1: r = 0.35, P ≤ 0.0001; IC: r = 0.25, P = 0.01). Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.

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Section: Discussionmentioning

confidence: 45%

“…The effects of the median sternotomy, hypothermia for myocardial protection, dissection of the internal mammary artery, and the use of cardiopulmonary bypass negatively influence lung function [1–4]. …”

Section: Introductionmentioning

confidence: 99%

Lung Function before and Two Days after Open-Heart Surgery

Urell

Westerdahl

Hedenström

et al. 2012

Critical Care Research and Practice

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“…Some studies confirm the relevance of the history of the patient, the presence of chronic obstructive pulmonary disease, smoking, obesity and age [2,[7][8][9][10]15,16]. They used spirometry to determine the values of forced vital capacity and forced expiratory volume in one second, measurement of maximum inspiratory and expiratory pressures by manometer and cirtometry for obtaining measurements of the circumferences and thoracoabdominal motion [2,7,10,[14][15][16].…”

Section: Reviewmentioning

confidence: 99%

Fisioterapia respiratória e sua aplicabilidade no período pré-operatório de cirurgia cardíaca

Miranda¹,

Padulla²,

Bortolatto³

2011

Rev Bras Cir Cardiovasc

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ResumoProcedimentos cirúrgicos torácicos podem alterar a mecânica respiratória, repercutindo na função pulmonar. A presença de profissionais fisioterapeutas é fundamental no preparo e na reabilitação dos indivíduos que são submetidos à cirurgia cardíaca, visto que dispõem de um grande arsenal de técnicas. O objetivo foi verificar a efetividade de exercícios respiratórios, com e sem a utilização de dispositivos, e o treinamento muscular respiratório pré-cirurgia cardíaca na redução das complicações pulmonares pós-operatórias. Mesmo existindo controvérsias a respeito de qual técnica utilizar, estudos demonstram a eficácia da fisioterapia respiratória pré-cirúrgica na prevenção e na redução de complicações pulmonares pós-operatórias. Descritores

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“…The pain is described as chest discomfort of noncardiac origin in up to 65% of cases and can coexist with pain in the upper extremities, neck, head, and midback area [4]. Acute postoperative pain after coronary artery bypass grafting (CABG) surgery adversely affects pulmonary function in the first two postoperative days and can potentially delay extubation and prolong hospital stay [5, 6], thereby adversely affecting patient recovery. Furthermore, acute pain can progress to chronic pain with hypoesthesia and allodynia along the surgical incision.…”

Section: Introductionmentioning

confidence: 99%

Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

Bouzia¹,

Tassoudis

Καρανικόλας

et al. 2017

Anesthesiology Research and Practice

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Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75 mg, and Group 3 received oral pregabalin 150 mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively. Results. Patients receiving pregabalin required fewer morphine boluses (10 in controls versus 6 in Group 1 versus 4 in Group 2, p = 0.000) and had lower pain scores at 8 hours (4 versus 3 versus 3, p = 0.001) and 3 months (3 versus 2 versus 2, p = 0.000) and lower morphine consumption at 8 hours (14 versus 13 versus 12 mg, p = 0.000) and 24 hours (19.5 versus 16 versus 15 mg, p = 0.000). Percentage of patients with sleep disturbances or requiring analgesics was lower in the pregabalin group and even lower with higher pregabalin dose (16/31 versus 5/31 versus 3/31, p = 0.000, and 26/31 versus 16/31 versus 10/31, p = 0.000, resp.) 3 months after surgery. Conclusion. Preoperative oral pregabalin 75 or 150 mg reduces postoperative morphine requirements and acute and chronic pain after cardiac surgery.

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Comportamento da dor e da função pulmonar em pacientes submetidos à cirurgia cardíaca via esternotomia

Cited by 34 publications

References 21 publications

Lung Function before and Two Days after Open-Heart Surgery

Lung Function before and Two Days after Open-Heart Surgery

Fisioterapia respiratória e sua aplicabilidade no período pré-operatório de cirurgia cardíaca

Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

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