A Comparative Study of Preemptive Effect of Pregabalin and Gabapentin on Postoperative Pain After Coronary Artery Bypass Graft Surgery

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Saeed Abdelaziz ◽  
Randa Ali Shoukry Mohamed ◽  
Mohamed Abdelmohsen Abdelnaeim Ismail ◽  
Ahmed Nabil Ahmed Talaat Mohamed
Keyword(s):  
Patient Satisfaction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Pain Control ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Morphine Consumption ◽  
Artery Bypass Graft

Abstract Background Pain that pursues coronary artery bypass graft (CABG) surgery is usually associated with increased both recovery duration and hospital stay. Patient outcome could be worsened owing to large doses of opioids for pain control through over sedation, and prolonged mechanical ventilation. This study was designed to evaluate the effect of preemptive gabapentinoids on post CABG surgery pain control. Objective to evaluate the effect of pre-operative administration of pregabalin and gabapentin in limiting the post-operative pain in coronary artery bypass surgeries. Patients and Methods Type of Study: Prospective double – blinded, randomized controlled Trial. After Approval is obtained from the research ethics committee of anesthesia and intensive care department, Ain Shams University. Study Setting: National Heart Institute, Egypt. Study Period: 6 months. Study Population: adult undergoing coronary artery bypass graft surgeries. Results The primary outcome of this study was to compare the effect of gabapentinoids on post CABG pain as reflected by morphine consumption. The secondary outcome was to address the influence of gabapentinoids on patient satisfaction post CABG, the incidence of respiratory depression, nausea, vomiting, ventilatory hours and length of hospital stay. Conclusion Pregabalin, and gabapentin both can be effective for reduction of post CABG morphine consumption and have better patient satisfaction if given preemptively with single dose preoperatively.

scholarly journals VALIDATION OF MAXIMUM OXYGEN CONSUMPTION (VO2 MAX) WITH SOCIETY OF THORACIC SURGEON (STS) RISK SCORE IN PREOPERATIVE ASSESSMENT OF PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT (CABG) SURGERY: A PILOT STUDY

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S897-903
Author(s):  
Imtiaz Ahmad Chaudhry ◽  
Farrah Pervaiz ◽  
Kaleem Ahmed ◽  
Mehwish Naseer ◽  
Aysha Siddiqa ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Scoring System ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Preoperative Assessment ◽  
Artery Bypass Graft ◽  
Vo2 Max

Objective: To validate VO2 max testing with society of thoracic surgeon (STS) score in the preoperative assessment of patients undergoing coronary artery bypass graft surgery. Study Design: This was a single center and observational study. Place and Duration of Study: Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi Methodology: Forty four adult patients undergoing elective on pump coronary artery bypass graft surgery with an EF of >45% were included in this study as per inclusion criteria through non probability consecutive sampling. Five patients were lost to follow up. In 39 patients preoperative society of thoracic surgeons scoring was done and VO2 max of these patients was calculated. After coronary artery bypass graft surgery these patients were followed for mortality and morbidity. The discriminative capacity of VO2 max was compared with the STS risk scoring system using Receiver Operating Characteristic curves (ROC-curves). Results: We analyzed the data of 39 patients male 35 (89.7%), female 4 (10.3%). Mean age of our study population was 55.0 ± 10.2 years and a mean BMI of 26.8 ± 3.81. There were 20 (54.1%) hypertensives, 2 (5.4%) diabetics and 5 (13.5%) smokers. There was only one patient with a history of previous myocardial infarction. Majority of the patients belonged to NYHA class II 30 (76.9%) with a mean EF of 56.6 ± 5.17. Prolonged Ventilation (>24 hrs) was significantly associated with lesser values of VO2 max with a p-value of 0.01. Similarly, post-operative mortality and prolonged hospital stay in the low VO2 max groups correlated with the trends predicted by the society of thoracic surgeons scoring system. Conclusion: We conclude from this study that low preoperative VO2 max levels correlated well with STS scoring system for predicting mortality, ventilation time and length of hospital stay.

scholarly journals 462 Factors Associated with Longer Post-Operative Hospital Stay Following First Time Coronary-Artery-Bypass-Graft (CABG)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Ishak ◽  
K Morcos ◽  
P Curry
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Hospital Stay ◽  
Renal Dysfunction ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Left Ventricular ◽  
Artery Bypass Graft ◽  
First Time

Abstract Prolonged post-operative hospital stay is associated with worse patient healthcare outcomes. Aim To identify parameters which correlate with longer post-operative hospital stay (POHS) following first time Coronary-Artery-Bypass-Graft (CABG) Method Data was collected retrospectively on 50 patients who underwent a first time CABG between 12/02/2020 – 21/09/2020 at the Golden Jubilee National Hospital (GJNH). Data included patient demographics, body-mass-index (BMI), presence of co-morbidities, peri-operative blood results, pre-operative renal dysfunction, left ventricular systolic dysfunction (LVSD), severity of left main stem disease, New York Heart Association (NYHA) Functional Classification score, number of grafts, cross-clamp time and bypass time. Results The mean POHS was 7.5 days. Patients with a POHS>7.5 days had a total mean POHS twice as long (12.07 vs 5.7 days, p < 0.001). They spent more time in intensive care unit (2.6 vs 0.97 days, P = 0.05), high dependency unit (2.5 vs 1.2 days, p = 0.005) and ward (7 vs 3.5 days, p = 0.001) compared to the shorter POHS group. They had a higher mean age (69 vs 65, p = 0.036), lower mean CrCl (80.32 vs 95.14, p = 0.141), higher mean renal dysfunction severity grades (0.8 vs 0.28, p = 0.014), higher mean LVSD severity grades (0.33 vs 0.17, p = 0.35) and higher mean NYHA scores (2.2 vs 1.88, p = 0.17). More of the patients had renal dysfunction (p = 0.01), were on ≥ 2 anticoagulants (p = 0.028), had sub-optimal pre-operative bloods (p = 0.075) and required blood transfusion post-operatively (p = 0.02). One patient in the longer POHS group died. Conclusions Longer POHS was associated with older age, worse renal function, presence of co-morbidities, sub-optimal peri-operative blood levels and requirement for post-operative blood transfusions.

A Comparative Study of the efficacy of preoperative of oral Pregabalin and placebo on acute Postoperative Pain After Coronary Artery Bypass Graft Surgery

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Ahmed Ibrahim Ahmed ◽  
Hatem Said Abdel Hamed ◽  
Nevein Gerges Fahmy ◽  
Wael Abdel Aziz Mohamed
Keyword(s):  
Coronary Artery ◽  
Postoperative Pain ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Pain Control ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Acute Postoperative Pain ◽  
Significant Difference

Abstract Background Pain that pursues coronary artery bypass graft (CABG) surgery is usually associated with increased both recovery duration and hospital stay. Patient outcome could be worsened owing to large doses of opioids for pain control through over sedation, and prolonged mechanical ventilation. This study was designed to evaluate the effect of preemptive pregabalin on post CABG surgery pain control. Objective To study the effect of pregabalin administration before surgery in the treatment of acute postoperative pain after coronary artery bypass surgery. To study the effect of pregabalin on the consumption of opioids for acute postoperative pain. Patients and Methods Type of Study: Prospective double – blinded, randomized controlled Trial. After Approval is obtained from the research ethics committee of anesthesia and intensive care department, Ain Shams University. Study Setting: National Heart Institute, Egypt. Study Period: 6 months. Study Population: adult undergoing coronary artery bypass graft surgeries. Results Analysis of VAS in the first 24 hours after extubation showed significant difference between Groups 1 and 2. Analysis of systolic blood pressure and heart rate in the first 24 hours showed no significant difference between Groups 1 and 2. It is important to note that because the observed “average” differences in systolic blood pressure and heart rate between groups were small, the clinical significance of such differences can be questioned. Furthermore, it would not be realistic to expect a big, dramatic benefit from a single intervention in a complex, multifactorial care process, such as in cardiac surgery. Given the complexity of these cases, we believe that even a small reduction in pain intensity is a meaningful improvement as we all try to improve care for these patients. Conclusion Pregabalin can be effective for reduction of post CABG pain and have better patient satisfaction if given preemptively with single dose preoperatively.

scholarly journals Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery

2019 ◽  
Vol 7 (1) ◽  
pp. e000703
Author(s):  
Saumeth Cardona ◽  
Katerina Tsegka ◽  
Francisco J Pasquel ◽  
Maya Fayfman ◽  
Limin Peng ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Insulin Therapy ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Stress Hyperglycemia ◽  
Cabg Surgery

AimsTo determine if treatment with sitagliptin, a dipeptidyl peptidase-4 inhibitor, can prevent stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery.MethodsWe conducted a pilot, double-blinded, placebo-controlled randomized trial in adults (18–80 years) without history of diabetes. Participants received sitagliptin or placebo once daily, starting the day prior to surgery and continued for up to 10 days. Primary outcome was differences in the frequency of stress hyperglycemia (blood glucose (BG) >180 mg/dL) after surgery among groups.ResultsWe randomized 32 participants to receive sitagliptin and 28 to placebo (mean age 64±10 years and HbA1c: 5.6%±0.5%). Treatment with sitagliptin resulted in lower BG levels prior to surgery (101±mg/dL vs 107±13 mg/dL, p=0.01); however, there were no differences in the mean BG concentration, proportion of patients who developed stress hyperglycemia (21% vs 22%, p>0.99), length of hospital stay, rate of perioperative complications and need for insulin therapy in the intensive care unit or during the hospital stay.ConclusionThe use of sitagliptin during the perioperative period did not prevent the development of stress hyperglycemia or need for insulin therapy in patients without diabetes undergoing CABG surgery.

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