Improved pain management outcomes with continuous infusion of a local anesthetic after thoracotomy

Wheatley, Grayson H.; Rosenbaum, David; Paul, Michelle C.; Dine, Alan; Wait, Michael A.; Meyer, Dan M.; Jessen, Michael E.; Ring, W. Steves; DiMaio, J. Michael

doi:10.1016/j.jtcvs.2005.02.011

Cited by 103 publications

(56 citation statements)

References 22 publications

(26 reference statements)

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“…Susan B et al [7] showed parasternal block and infiltration of local Bupivacaine in the sternotomy wound and mediastinal tube sites can be a useful analgesic adjunct in the first four to six hours after cardiac surgery. Panagiotakopoulos V showed that 64% of patients didn't experience any significant pain at all, 29% experienced improved pain compared with the other cardiac surgical patients and only 7% of the patients enrolled in this study experienced the "usual" pain [6,19,[21][22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Early extubation is safe and improves cardiac function by increasing preload as capacitance blood volume shifts into the chest. To achieve this target of early extubation, the early postoperative period in cardiac surgical patients is the crucial time to establish stable haemodynamics, alert mental status and adequate pain control [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Panagiotakopoulos V showed that 64% of patients didn't experience any significant pain at all, 29% experienced improved pain compared with the other cardiac surgical patients and only 7% of the patients enrolled in this study experienced the "usual" pain [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Parasternal Injection of Bupivacaine on Postopeartive Pain for Early Extubation in Patients Undergoing Coronary Artery Bypass Surgery

Rahman¹,

Siddiqi²,

Husain³

et al. 2016

JCCR

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Objectives: The aim of this study was to determine the efficacy of parasternal injection of Bupivacaine on postoperative pain for early extubation in patients undergoing coronary artery bypass grafting. Material and methods:Patients admitted throughout patient department for elective primary coronary artery bypass surgery into the surgical ward were enrolled for the study. A total of 35 patients were randomized into two groups, (Bupivacaine) group 1 13 (37.14%) and (Placebo) group 2 15 (42.85%). Patients were induced with standard anesthetic protocols. Bupivacaine injection 0.5% at 2mg per kg was diluted in 50 mls syringe with normal saline and 50mls of normal saline was used as Placebo. Identical syringes marked with a study number of patient were delivered to the operating theaters. Both the surgeon and the anesthetist were blinded of the content of the solution. At the end of the procedure the injection was infiltrated into the parasternal wound before placing the sternal wires. Patients were assessed in the intensive care unit by the anesthetist for early extubation. At the time of extubation pain intensity was measured with Visual analogue scale system and recorded.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Parasternal Injection of Bupivacaine on Postopeartive Pain for Early Extubation in Patients Undergoing Coronary Artery Bypass Surgery

Rahman¹,

Siddiqi²,

Husain³

et al. 2016

JCCR

View full text Add to dashboard Cite

show abstract

“…Further, it has been recognized that the longer the pain remains unattended; the patient becomes more sensitive to painful stimuli, prolong recovery, increase the duration of stay in the hospital and increase health care costs. [4] Epidural local anaesthetics are capable of maintaining prolonged analgesia in the postoperative period when administered by intermittent injections or continuous infusion. [5,6,7] Since intermittent bolus dosing has drawbacks of inconsistent analgesia, potential toxicity and compromised sterility continuous infusion of 0.125% bupivacaine is the ideal LA for epidural analgesia as it produces neural blockade of long duration, differential blockade of sensory rather than motor fibres.…”

Section: Discussionmentioning

confidence: 99%

Disposable Non-Mechanical Elastomeric Balloon Pump for Continuous Epidural Infusion: An Effective and Reliable Means for Postoperative Analgesia

Saloi¹,

Taye²,

Paul³

2016

jemds

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Postoperative pain an unpleasant sensory and emotional experience is one of the most challenging and gratifying domains to treat. Aim is here to assess effectiveness of postoperative pain relief, side effects and complications while using non-mechanical disposable elastomeric pump as continuous epidural infusion. PATIENTS AND METHODSThe present study has been carried out on thirty patients in postoperative wards. At the end of operation the Elastomeric pump containing 125ml of bupivacaine (0.125%) was connected with the epidural catheter Pain was assessed by VAS scoring system ranging from 0 to 10. Haemodynamic parameters, quality of analgesia, degree of motor block, and adverse effect encountered were recorded at two hours interval for 24 hours at the end of two hours of subarachnoid block when operation is over. RESULTS AND OBSERVATIONSNone of our patients had shown any clinically significant changes in their cardiorespiratory indices in the postoperative period. All the patients at 0 hr. were having VAS score of 0 and till 22 hours enjoyed good pain relief, i.e. VAS of 3-4. Infusion is not always steady as set by the manufacturer. There is no motor blockade after 16 hours (Bromage-0). Insignificant number of patients experienced nausea or vomiting and backache. CONCLUSIONSElastomeric balloon pumps is a reliable device to deliver LA agents steadily and safely with 0.125% bupivacaine as continuous epidural.

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“…Wheatley et al found that using an elastomeric pump is a safe and effective adjunct for post-thoracotomy pain relief. Also, patients had lower pain scores and decreased narcotic need when compared to thoracic epidural analgesia alone [136]. Although local anesthetic toxicity is always a concern with infusions, the incidence of systemic toxicity is low [116].…”

Section: Elastomeric Pumpsmentioning

confidence: 98%

Anesthesia for Thoracic Surgical Procedures

Tsai¹,

Moon²,

Vachhani³

et al. 2013

Principles and Practice of Cardiothoracic Surgery

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Improved pain management outcomes with continuous infusion of a local anesthetic after thoracotomy

Cited by 103 publications

References 22 publications

Efficacy of Parasternal Injection of Bupivacaine on Postopeartive Pain for Early Extubation in Patients Undergoing Coronary Artery Bypass Surgery

Efficacy of Parasternal Injection of Bupivacaine on Postopeartive Pain for Early Extubation in Patients Undergoing Coronary Artery Bypass Surgery

Disposable Non-Mechanical Elastomeric Balloon Pump for Continuous Epidural Infusion: An Effective and Reliable Means for Postoperative Analgesia

Anesthesia for Thoracic Surgical Procedures

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