Pain after Cardiac Surgery

Lahtinen, Pasi; Kokki, Hannu; Hynynen, Markku

doi:10.1097/00000542-200610000-00026

Cited by 252 publications

(92 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our analysis, pneumonia was a primary driver of HAI rates. Interventions aimed at preventing pneumonia and other pulmonary complications may include: encouraging pre-operative respiratory muscle training 20 and smoking cessation, 21, 22 improving post-operative analgesia, 23, 24 encouraging post-operative incentive spirometry use, 25 and selective use of post-operative continuous positive airway pressure. 26, 27 Future research is warranted to assess the effectiveness of these interventions in reducing the pneumonia-related HAI rates in this setting.…”

Section: Discussionmentioning

confidence: 99%

Center-Level Variation in Infection Rates After Coronary Artery Bypass Grafting

Shih

Zhang

Kommareddi

et al. 2014

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

Background Healthcare acquired infections (HAIs) are a leading cause of morbidity and mortality after cardiac surgery. Prior work has identified a number of patient-related risk factors associated with HAIs. We hypothesized that rates of HAIs would differ across institutions, in part attributed to differences in case mix. Methods and Results We analyzed 20,896 patients undergoing isolated coronary artery bypass grafting (CABG) surgery at 33 medical centers in Michigan between 1/1/2009–6/30/2012. Overall HAIs included pneumonia, sepsis/septicemia, and surgical site infections, including deep sternal wound, thoracotomy, and harvest/cannulation site infections. We excluded patients presenting with endocarditis. Predicted rates of HAIs were estimated using multivariable logistic regression. Overall rate of HAI was 5.1% (1,071 of 20,896) [isolated pneumonia: 3.1% (n=644), isolated sepsis/septicemia: 0.5% (n=99), isolated deep sternal wound infection: 0.5% (n=96), isolated harvest/cannulation site: 0.5% (n=97), isolated thoracotomy: 0.02% (n=5), multiple infections: 0.6% (n=130)]. HAI subtypes differed across strata of center-level HAI rates. While predicted risk of HAI differed in absolute terms by 2.8% across centers (3.9%–6.7%, min:max), observed rates varied 18.2% (0.9%–19.1%). Conclusions There was an 18.2% difference in observed HAI rates across medical centers among patients undergoing isolated CABG surgery. This variability could not be explained by patient case mix. Future work should focus on the impact of other factors (e.g. organizational and systems of clinical care) on risk of HAIs.

show abstract

Section: Discussionmentioning

confidence: 99%

Center-Level Variation in Infection Rates After Coronary Artery Bypass Grafting

Shih

Zhang

Kommareddi

et al. 2014

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

show abstract

“…There is a higher incidence of chronic (21% -55%) [1] pain in cardiac surgery patients due to various reasons. Pain after cardiac surgery is different from other surgeries mainly because of various sites of origin of pain and several aggravating factors.…”

Section: Introductionmentioning

confidence: 99%

A Quality Improvement Survey to Assess Pain Management in Cardiac Surgery Patients

Hamid¹,

Gangwani²,

Akhtar³

2015

OJAnes

View full text Add to dashboard Cite

Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.

show abstract

“…Persistent pain since the operation is commonly described as chest pain with movement4 and is often musculoskeletal in origin.…”

Section: What To Cover On Initial Assessment?mentioning

confidence: 99%

“…Recurrent or chronic chest pain after CABG can be extremely worrying for the patient and affect their quality of life 3. In a prospective cohort study (183 patients), a third of patients reported chronic chest pain on movement and 17% reported chest pain at rest at one year after CABG 4. This presents a diagnostic challenge in primary care and requires prompt investigation 5…”

mentioning

confidence: 99%