scholarly journals Continuous Incisional Lidocaine in Pediatric Patients following Open Heart Surgery

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Sarah Nicole Fernández ◽  
Blanca Toledo ◽  
Jesús Cebrián ◽  
Ramón Pérez-Caballero ◽  
Jesús López-Herce ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Pediatric Patients ◽  
Open Heart Surgery ◽  
Median Sternotomy ◽  
Control Group ◽  
Blood Levels ◽  
Open Heart ◽  
Historical Cohort ◽  
Level Of Consciousness ◽  
Drug Doses

Continuous incisional lidocaine infusion has been proposed as an adjunctive therapy in the management of postoperative pain in adult patients. The aim of this study was to determine the efficacy and safety of a continuous subcutaneous lidocaine infusion in pediatric patients following open heart surgery. All patients receiving a subcutaneous lidocaine infusion in median sternotomy incisions after open heart surgery during 2 consecutive years were included in the study. A historical cohort of patients was used as a control group. Demographic variables (age, size, and surgical procedure), variables related to sedation and analgesia (COMFORT and analgesia scales, drug doses, and duration), and complications were registered. 106 patients in the lidocaine infusion group and 79 patients in the control group were included. Incisional analgesia was effective for the treatment of pain as it reduced the dose and duration of intravenous fentanyl (odds ratio (OR) 6.26, confidence interval (CI) 95%: 2.48-15.97, p = 0.001 ; OR 4.30, CI 95%: 2.09-8.84, p = 0.001 , respectively). The reduction in fentanyl use was more important in children over two years of age. Adverse effects were seen in three children (2.8%): they all had decreased level of consciousness, and one of them presented seizures as well. Two of these three patients had lidocaine levels over 2 mcg/ml. A continuous lidocaine incisional infusion is effective for the treatment of pain after open heart surgery. This procedure reduced intravenous analgesic drug requirements in pediatric patients undergoing a median sternotomy incision. Although the incidence of secondary effects is low, monitoring of neurologic status and lidocaine blood levels are recommended in all patients.

scholarly journals The Impact of Perioperative Viscoelastic Test Application on Blood Product Usage and Outcome in Cardiac Surgery; Regional Cardiac Surgery Center Experience

2021 ◽  
Author(s):  
Murat Aksun ◽  
Saliha Aksun ◽  
Mehmet Ali Çoşar ◽  
Elif Neziroğlu ◽  
Senem Girgin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Experience ◽  
Heart Surgery ◽  
Blood Product ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart ◽  
Blood Products ◽  
Product Use ◽  
The Impact

Objective: Thromboelastography (TEG) is a diagnostic modality that gives information about coagulation. Despite all blood-preserving precautions in open heart surgery there are blood losses and the use of blood and blood products becomes inevitable. TEG is mostly not available in every center and habits, trends and clinical experience in blood use create the possibility of causing unnecessary use of blood and blood products. In this study, it was aimed to determine the effect of the use of thromboelastography on the use of blood and blood products in cardiac surgery. Methods: Two hundred patients between 18-70 years old who underwent open heart surgery were included in the study. After the cardiopulmonary bypass (CPB), the cases were confirmed to have an Activated Clotting Time (ACT) value in the range of 120-150 sec after protamine administration. In 100 patients in the TEG group, the coagulation status was evaluated with TEG and it was decided how to apply blood and blood product use. Blood and blood product use was applied to 100 patients in the control group based on clinical experience and foresight. The total amount of blood and blood product used, fluid balance, need for inotropics, mechanical ventilator time, complications, duration of intensive care and discharge times were recorded. Results: Use of Fresh Frozen Plasma (FFP) at the after CPB in the TEG group was statistically significantly lower than that of the control group FFP (p<0.05). Postoperative FFP and postoperative platelet use in the study group were statistically significantly lower than in the postoperative FFP and postoperative platelet values of the control group (p <0.05). Conclusion: The use of thromboelastography is a very useful monitoring in terms of reducing FFP use after CPB and reducing FFP and platelet usage in the postoperative period. In this way, the unnecessary use of blood and blood products can be prevented.

Procalcitonin kinetics in pediatric patients with systemic inflammatory response after open heart surgery

2006 ◽  
Vol 32 (6) ◽  
pp. 881-887 ◽  
Author(s):  
Serdar Celebi ◽  
Ozge Koner ◽  
Ferdi Menda ◽  
Huriye Balci ◽  
Alican Hatemi ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Heart Surgery ◽  
Pediatric Patients ◽  
Open Heart Surgery ◽  
Systemic Inflammatory Response ◽  
Open Heart

Cardiac Compression due to Closure of the Median Sternotomy in Open Heart Surgery

CHEST Journal ◽  
1975 ◽  
Vol 67 (1) ◽  
pp. 113-114 ◽  
Author(s):  
Mohammad Riahi ◽  
Luis A. Tomatis ◽  
Ralph J. Schlosser ◽  
Enrique Bertolozzi ◽  
Daniel W. Johnston
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Median Sternotomy ◽  
Open Heart ◽  
Cardiac Compression

Open-heart surgery in pediatric patients with end-stage liver disease

2004 ◽  
Vol 78 (2) ◽  
pp. e30-e33 ◽  
Author(s):  
Emile A Bacha ◽  
Joel Hardin ◽  
David C Cronin ◽  
Lynda Brady ◽  
Michael J Millis ◽  
...  
Keyword(s):  
Liver Disease ◽  
Heart Surgery ◽  
Pediatric Patients ◽  
Open Heart Surgery ◽  
Open Heart ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals The Effect of Distraction with a Loved One’s Voice on Pain Reduction While Extracting the Chest Tube after Open Heart Surgery

2019 ◽  
Vol 12 (1) ◽  
pp. 6-10
Author(s):  
Hakimeh Sheykhasadi ◽  
Abbas Abbaszadeh ◽  
Homira Bonakdar ◽  
Fatemeh Salmani ◽  
Asghar Tavan ◽  
...  
Keyword(s):  
Chest Tube ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart ◽  
Care Providers ◽  
Tube Removal ◽  
Significant Difference ◽  
Chest Tube Removal ◽  
The Impact

Background:One of the forms of ost-operative care after open heart surgery is controlling the pain resulting from chest tube insertion. Management of pain is considered vital and requires the awareness of health care providers. One of the main responsibilities of nurses is to prepare patients for invasive procedures such as the removal of the chest tube. This study was designed to analyze the impact of a loved one’s voice for distraction in patients undergoing open heart surgery.Methods:This study was a clinical trial. The research sample was randomly selected from patients undergoing open heart surgery. In this study, the number of samples for each group was considered to be 64 people, where the total number of samples was 128 people. The data collection tools included Visual Analog Scale (VAS) assessment tool and a researcher-made questionnaire. After selecting the eligible samples and obtaining the informed consent, each patient was randomly assigned to one of the two groups (intervention group and control group). The pain was measured before, immediately, and 10 minutes after removing the chest tube.Results:The findings of this study indicated that the two groups had no statistically significant differences in pain before chest tube removal. The mean pain during chest tube removal and 10 minutes later in both groups indicated a significant difference based on Mann-Whitney test (P<0.001).Conclusion:This study showed that a loved one’s voice is effective in reducing pain during chest tube removal after open heart surgery.

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