Role of Endarterectomy in Surgical Myocardial Revascularisation Among Diffuse Coronary Artery Disease Patients

Ranjan, Redoy; Adhikary, Dipal Krishna; Saha, Heemel; Saha, Sanjoy Kumar; Hassan, Kamrul; Adhikary, Asit Baran

doi:10.1016/j.hlc.2019.02.123

Cited by 1 publication

(8 citation statements)

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“…Following cardiac surgery, pain disrupts the humoral and neuroendocrine systems' equilibrium, increasing stress hormone levels and myocardial oxygen demand. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 As a result, arrhythmias and myocardial ischemia are increased. Pain also impairs mechanical ventilation and mobility restriction.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Surgical stress, pain, and breathing difficulties contribute to the morbidity and mortality associated with heart surgery. Following cardiac surgery, pain disrupts the humoral and neuroendocrine systems' equilibrium, increasing stress hormone levels and myocardial oxygen demand 5–12 . As a result, arrhythmias and myocardial ischemia are increased.…”

Section: Literature Reviewmentioning

confidence: 99%

“…9 Traditionally opioids, nonsteroidal anti-inflammatory medications (NSAIDs), or a combination of both, are being used to provide analgesia following cardiac surgery, which is linked to adverse side effects. 10,11 Longer-acting opioids, such as morphine, delayed postoperative tracheal extubation due to drowsiness and respiratory depression. Concerns about adverse events NSAIDs include altered stomach mucosal barrier, renal tubular function, and platelet aggregation inhibition, limiting their usage in cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Traditionally opioids, nonsteroidal anti‐inflammatory medications (NSAIDs), or a combination of both, are being used to provide analgesia following cardiac surgery, which is linked to adverse side effects 10,11 . Longer‐acting opioids, such as morphine, delayed postoperative tracheal extubation due to drowsiness and respiratory depression.…”

Section: Introductionmentioning

confidence: 99%

“…As a general rule, single-modality therapy is often recommended to treat immediate postoperative pain. [10][11][12][13] In the current era of early extubation (fast-tracking), cardiac anesthesiologists are investigating novel options for adequate analgesia in patients undergoing cardiac surgery that are not traditional opioids and NSAIDs. 1,14 This current study will aim to evaluate an effective method of optimum postoperative analgesia using either TEA (Inj.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of traditional and upper thoracic epidural analgesia after off‐pump coronary artery bypass graft surgery: A Quasi‐experimental study

Saha

Ranjan

Adhikary

2022

Health Science Reports

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Background and Aims Surgical trauma initiates changes in central and peripheral nervous systems that need to be treated therapeutically to facilitate postoperative pain. The quality of postoperative analgesia is expected to affect clinical outcomes positively. Albeit optimal pain relief following cardiac surgery is often complex, researchers have tried to explore several techniques other than conventional ones during the last decade to find a unique analgesic method for postcardiac surgical patients. This study aims to find a unique analgesic approach that maximizes patient satisfaction after off‐pump coronary artery bypass graft (OPCABG) surgery. Methods The current study will compare the analgesic effect of upper thoracic epidural analgesia (TEA) with conventional analgesia after OPCAB graft surgery. For this, we will use a Quasi‐experimental study design. Patients admitted for coronary artery bypass graft (CABG) surgery will be assigned into two groups. The control group (conventional) will receive intravenous opioids and nonsteroidal anti‐inflammatory medications, and the study (case) group (TEA) will receive Inj. Bupivacaine 0.25% as an infusion through the epidural catheter. Physiologic parameters like hemodynamic and respiratory variables and pain scores will be recorded in predesigned format periodically. Results We expect to analyze a total of 130 consecutive off‐pump CABG surgery patients in Group A (Case, 65 patients) and Group B (Control, 65 patients). Study variables will be the visual analog scale score, hemodynamic parameters (heart rate, mean arterial pressure, and respiratory parameters (respiratory rate, PaO 2 , PaCO 2 , PEFR, FEV 1 ). After data collection, the result will be analyzed and published in the public domain and in journals. Conclusion We expect thoracic epidural analgesia with local anesthetics will be a reliable postoperative analgesic option.

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