scholarly journals Characteristics of postoperative pain after mini invasive and conventional mitral surgery in Hanoi Heart Hospital

2021 ◽  
Vol 35 ◽  
pp. 254-261
Author(s):  
Phung Thi Hai Anh ◽  
Dang Quang Huy ◽  
Nguyen Minh Ngoc ◽  
Le Quang Thien ◽  
Nguyen Thi Hoang Huyen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Mitral Valve ◽  
Pain Reduction ◽  
Cross Sectional Study ◽  
Mitral Valve Surgery ◽  
Erector Spinae ◽  
Conventional Surgery ◽  
Cross Sectional ◽  
Mitral Surgery ◽  
Heart Hospital

Introduction: Mini invasive mitral valve surgery had some advantages over conventional surgery in recovery and cosmestic results. Postoperative pain was an interested factor for comparing these two methods, with reported results remained unclear. We realized this study for evaluate the characteristics of postoperative pain between mini invasive and conventional mitral surgery in Hanoi Heart Hospital. Methods: A cross sectional study on patient underwent mitral valve replacement with mini invasive and conventional sternotomy approach. Results: There were 66 patients in the study, divided into 2 group: 43 patient underwent conventional surgery and 23 patient underwent mini invasive surgery. Mean age was 50,7 ± 9,3, female was 78,8% and mean BMI was 20,9 ± 2,7. Erector spinae plane (ESP) block was performed on 16 patients (24,2%) of conventional surgery group. The VAS score at 3 days, 7 days , and 1 month after surgery was 7,7 ± 1,2; 5,2 ± 1,5; 0,9 ± 1,1 in sternotomy group and 6,6 ± 1,6; 3,8 ± 1,5; 1,7 ± 0,9 in mini invasive group, respectively. In patients with ESP block, mean dose of morphine administered in first two days was 0 and 2,3 ± 5,0 mg/kg comparing to the dose of 19,7 ± 5,5 và 17,7 ± 7,1 in sternotomy patients without ESP block. Conclusions: Postoperative pain reduction may not be an advantage of mini invasive mitral surrgery comparing to conventional surrgery, but the time for pain suffering in this group was shorter. ESP was an efficient method for early pain reduction after conventional surgery.

Características Clínicas Y Quirurgicas De Pacientes Sometidos A Cirugía De Válvula Mitral En Una Institucion De Salud De Barranquilla (Colombia)

2019 ◽  
Vol 39 (3) ◽  
Author(s):  
Maria Angela Castellanos Gutierrez ◽  
Jorge Armando Acosta Buelvas ◽  
Ronald Yesid Maestre Serrano
Keyword(s):  
Mitral Valve ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Diagnostic Methods ◽  
Accurate Identification ◽  
Cross Sectional ◽  
Health Institution ◽  
El Sistema

<p>[Clinical and surgical characteristics of patients undergoing mitral valve surgery at a health institution in Barranquilla, Colombia]</p><p>Resumen<br />Introducción: la incidencia de las anomalías valvulares cardiacas ha aumentado entre otras razones por los avances en métodos diagnósticos y conocimiento de predecesores etiológicos como desencadenantes de la condición clínica, que inicia la probabilidad diagnostica y seguimiento temprano en pacientes en estadios iniciales de la enfermedad, disminuyendo de esta manera el impacto económico por aumento de la morbimortalidad. Objetivo: describir las características clínicas y quirúrgicas de pacientes sometidos a cirugía de válvula mitral en una institución prestadora de servicios de salud de referencia para el distrito de Barranquilla, Colombia, durante los años 2014 a 2016. Metodología: estudio descriptivo, en el que se revisó de forma retrospectiva las historias clínicas de pacientes con patología mitral que requirieron intervención quirúrgica de tipo plastia, cambio biológico o mecánico, entre los años 2014 y 2016. El análisis de la información se realizó a través del software SPSS. Resultados: durante el periodo de estudio se realizaron 276 cirugías valvulares en la institución de salud objeto de estudio, de las cuales 98 fueron cirugías sobre válvula mitral, excluyéndose 20 historias clínicas que no contenían la totalidad de las variables analizadas. El antecedente clínico más frecuente fue la enfermedad coronaria (38,5%), seguido del infarto de miocardio (23,1%); el 20,5% de los pacientes presentaron arritmia tipo fibrilación auricular y la cirugía sobre válvula mitral más realizada fue recambio biológico (42%). Conclusión: las características clínicas y quirúrgicas de los pacientes incluidos en el estudio, son similares a las descritas en la literatura nacional e internacional, por lo que podría tomarse como precedente de presentación y de esta manera ir construyendo una clínica para la identificación rápida y veraz de los pacientes con alteraciones valvulares, permitiendo su abordaje temprano y disminuyendo la carga económica para el sistema de salud.  <br /><br />Abstract<br />Introduction: cardiac valvular anomalies have increased their presentation, in part due to advances in diagnostic methods and knowledge of etiological predecessors as triggers of the clinical condition that initiates the diagnostic probability and early follow-up in patients in the initial stages of the disease, thus decreasing the economic impact due to increased morbidity and mortality. Objective: to describe the clinical and surgical characteristics of patients undergoing mitral valve surgery at a reference center in the district of Barranquilla during the years 2014 to 2016.Methodology: descriptive, retrospective, cross-sectional study in a health institution in the district of Barranquilla. Patients with mitral pathology who required surgical intervention of the plasty type, biological or mechanical change, were included between 2014 and 2016. Data analysis performed in SPSS according to the nature of the variables. Results: during the study period, 276 valve surgeries were performed, of which 98 were valve surgeries, 20 patients were excluded due to incomplete clinical history; the most prevalent antecedent was coronary disease in 38.5% followed by myocardial infarction with 23.1%; 20.5% of the patients presented arrhythmia type atrial fibrillation; the most performed mitral valve surgery was a 42% biological replacement. Conclusion: the clinical and surgical characteristics of the patients included in the study, correspond to those described in national and international literature, so it could be taken as a precedent for presentation and thus build a presentation clinic for quick and accurate identification of the patients with valvular alterations, allowing their early approach and decreasing the economic burden for the health system.<br /><br /></p>

scholarly journals Pharmacological analgesia in neonates undergoing cardiac surgery

2008 ◽  
Vol 16 (4) ◽  
pp. 727-732 ◽  
Author(s):  
Mariana Bueno ◽  
Amélia Fumiko Kimura ◽  
Cibele Andrucioli de Mattos Pimenta
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Pain Control ◽  
Private Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Postoperative Pain Control ◽  
Fentanyl Citrate ◽  
Cross Sectional ◽  
The City

The objectives of this study were to verify the frequency of pharmacological analgesia and the occurrence of postoperative pain in neonates undergoing cardiac surgery. METHODS: This is a cross-sectional study and data were collected from 30 medical charts of neonates who underwent cardiac surgery in a private hospital in the city of São Paulo. RESULTS: The majority (96.6%) of neonates received analgesia: 18 (60.0%) received continuous analgesics, five (16.7%) received intermittent drugs, and six (20.0%) received a combination of continuous and intermittent analgesics. Fentanyl citrate was continuously administered to 24 (80.0%) neonates. Intermittent dipyrone and morphine was administered to ten (33.3%) and one (3.3%) neonates, respectively. Pain registers were observed in 17 (56.7%) medical charts and the occurrence of pain among neonates who received analgesics was 53.4%. CONCLUSION: There was no efficacy in pharmacological postoperative pain control in the neonates included in this study.

Lumbar Multifidus and Erector Spinae Muscle Synergies in Patients with Nonspecific Low Back Pain During Prone Hip Extension: A Cross‐sectional Study

PM&R ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 694-702 ◽  
Author(s):  
Peemongkon Wattananon ◽  
Sheri P. Silfies ◽  
Jarugool Tretriluxana ◽  
Wattana Jalayondeja
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cross Sectional Study ◽  
Erector Spinae ◽  
Muscle Synergies ◽  
Low Back ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lumbar Multifidus ◽  
Hip Extension

scholarly journals Undesirable Postoperative Anesthesia Outcomes at Two National Referral Hospitals: A Cross-Sectional Study in Eritrea

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yonatan Mehari Andemeskel ◽  
Traudl Elsholz ◽  
Ghidey Gebreyohannes ◽  
Eyasu H. Tesfamariam
Keyword(s):  
Postoperative Pain ◽  
Cross Sectional Study ◽  
Care Patient ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Satisfaction Questionnaire ◽  
Different Types ◽  
Referral Hospitals ◽  
Postoperative Problems ◽  
Undesirable Outcome

Background. Postoperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the postoperative period. Method. A cross-sectional study design was applied on 470 patients who underwent different types of surgeries within a three-month period. Patients were interviewed 24 hours after operation (POD 1) using the Leiden Perioperative care Patient Satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered, and the measurements of that dimension are presented in this report. Items of the dimension were standardized and measured using a five-point Likert scale from “Not at all” to “Extremely.” Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Results. The prevalence were computed in two manners, prevalence of those with ‘at least a little bit’ outcomes, which was computed to see the total occurrence of these outcomes, and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, postoperative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6%, respectively. The rest of the postoperative undesirable outcomes were less frequently reported. Conclusion. Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed.

scholarly journals ERECTOR SPINAE AND SCOLIOSIS IN A POPULATION WITH CEREBRAL PALSY: A PRELIMINARY STUDY

2018 ◽  
Vol 17 (1) ◽  
pp. 14-18
Author(s):  
OSAMA J. ALÍ-MORELL ◽  
FÉLIX ZURITA-ORTEGA ◽  
BERENICE FERNÁNDEZ-ESTÉVEZ ◽  
BEATRIZ PADILLA-OBISPO ◽  
ROBERTO MARTÍNEZ-PORCEL
Keyword(s):  
Cerebral Palsy ◽  
Case Series ◽  
Muscular Activity ◽  
Population Level ◽  
Vestibular Stimulation ◽  
Cross Sectional Study ◽  
Erector Spinae ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Cobb Method

ABSTRACT Objective: To verify the relation of muscular response to the vestibular stimulation of the erector spinae, specifically longissimus thoracis and iliocostalis lumborum, with the origin of scoliosis in a population of individuals with level V cerebral palsy of the Gross Motor Function Classification System (GMFCS). Methods: Cross-sectional study of 12 individuals aged between four and 14 years. The muscular activity of the longissimus thoracis and iliocostalis lumborum was recorded by electromyography in the presence of anteroposterior and lateral imbalances, comparing it with that obtained in sitting position without imbalances. Scoliosis was assessed by radiological study following Cobb method. Results: Statistically significant differences were found between correct responses of both muscles to anteroposterior imbalances and absence of right thoracolumbar scoliosis (p=0.005; p=0.028), left thoracic scoliosis (p=0.005; p=0.046) and right lumbar scoliosis (p=0.005; p=0.046). Conclusions: The symmetry of muscular responses to anteroposterior imbalances, both of longissimus thoracis and iliocostalis lumborum, seems to be one of the factors that prevent the development of spine deviations in this population. Level of evidence: IV. Type of Study: Case series

The Use of the Mini-Cardiopulmonary Bypass Circuit in Robotic Mitral Valve Surgery

2008 ◽  
Vol 3 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Robert W. Emery ◽  
Goya V. Raikar ◽  
Barbara Murphy ◽  
Anton Rohan ◽  
Kris Nielsen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
High Efficiency ◽  
Mitral Valve Surgery ◽  
Circulatory Support ◽  
Valve Repair ◽  
Mitral Repair ◽  
Perfusion Time ◽  
Mitral Surgery

Background Computer enabled robotic mitral valve repair cases have longer cross-clamp and perfusion times because of the more technically difficult procedure. To modify some of the well-documented side effects of standard cardiopulmonary bypass (CPB), we used a new mini-circuit on three robotic mitral cases. Methods Three patients having mitral valve repair (triangular resection of P2 and annuloplasty ring) using the daVinci Robot (Intuitive Surgical, Sunnyvale, CA) had circulatory support using a modified Resting Heart System (Medtronic, Inc., Fridley, MN), a vertically oriented space saving CPB configuration incorporating a high efficiency miniaturized oxygenator, centrifugal pump, shortened heparin coated tubing and an air evacuation system with a closed circuit. Results All patients had successful mitral repair (echo = 0 to trace residual leakage) under a cross-clamp time of 161 ± 54 minutes and perfusion time of 229 ± 31 minutes. No blood was given during CPB and 0.7 ± 1.2 red cell units after the CPB run and 0.7 ± 1.2 units during the postoperative course. Conclusion Miniaturized bypass circuit reducing the level of necessary anticoagulation, hemodilation, and blood trauma can be used despite the increased perfusion time necessary for robotic mitral surgery.

scholarly journals Proportion of immediate severe postoperative pain in laparoscopic sterilization under general anaesthesia: A cross-sectional study (postoperative pain in laparoscopic sterilization)

2021 ◽  
Vol 43 (5-6) ◽  
pp. 111-116
Author(s):  
Girijanandan Menon ◽  
Manjit George
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Severe Postoperative Pain ◽  
Numerical Rating ◽  
Laparoscopic Sterilization

Background: Effective control of immediate post operative abdominal pain following laparoscopic sterilization is challenging. The objective of the study was to estimate the incidence of immediate severe postoperative pain following laparoscopic sterilization under general anaesthesia by the proportion of patients with the pain assessed on a numerical rating scale. Methods: A cross sectional study was conducted with the approval of institutional review board and ethics committee. Fifty seven participants with written informed consent underwent the study over a period of six months. Pain was assessed by a trained recovery nurse and data was collected and analyzed. The main outcome measure was immediate severe post operative pain on numerical rating scale (NRS). Results: Among the 57 participants, 14 (24.6%) had immediate severe post operative pain with median score of five in the inter quartile range of 0 to 5.75 and 43 (75.4%) participants had no severe pain. Conclusion: The incidence of immediate severe postoperative abdominal pain after laparoscopic sterilization under general anaesthesia is high. Therefore, the management of pain following laparoscopic sterilization requires individually based multimodal analgesia.

scholarly journals Morphometric Study of Mitral Valve Annulus in Iran

2018 ◽  
Vol 7 ◽  
pp. e1078
Author(s):  
Tahereh Mohtaj ◽  
Mathias H. Aazami ◽  
Ghassem Sazegar ◽  
Hoorak Poorzand ◽  
Aria Hedjazi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Mitral Valve ◽  
Age Groups ◽  
Mitral Annulus ◽  
Cross Sectional Study ◽  
Morphometric Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Male And Female ◽  
Valve Annulus

Background: This study aimed to determine the normal dimensions of the mitral annulus (MA) in Iranian population. Materials and Methods: This cross-sectional study was conducted using 88 fresh hearts of male and female cadavers for six months in Mashhad, Iran. Normal data were determined by measuring the exact dimensions of the MA in fresh hearts of patients who had died of non-cardiac causes and considering some parameters such as age, gender, stature, and weight. Images of the valves and leaflets were prepared by marking the anterior (A2, midpoint of anterior) and posterior areas of P1, P2, and P3 using a needle. To analyze the data, SPSS version 16 was used. Results: The means of anatomic area, anatomic perimeter, inter-commissural distance, A2-P1, A2-P2, A2-P3, Base-P1, Base-P2, Base-P3, and Base-A were 14±1.28, 8.3±1, 2.7±0.42, 2.27±0.37, 2.3±0.43, 2.06±0.35, 1.66±0.43, 1.2±0.97, 1.5±0.66, and 3.2±0.52, respectively. Comparison of the age groups regarding valve leaflets showed that Strut-P1 and Base-P2 were significantly different. Comparison of the valve leaflets and sub-valve indicators between the two genders reflected no significant differences. Age groups differed significantly in terms of Strut-P1 and Base-P2 (P=0.004 and P=00.1, respectively). Conclusions: A2-P3, A2-P1, anatomic perimeter, and anatomic area were found to be related to gender. A2-P1 and A2-P2 and some leaflet indicators such as Strut-P1 and Base-P2 were associated with age, whereas Base-P2 was affected by body mass index. [GMJ.2018;7:e1078]

scholarly journals SEVERE MITRAL STENOSIS;

2017 ◽  
Vol 24 (06) ◽  
pp. 850-854
Author(s):  
Haroon Aziz Khan Babar ◽  
Abubakr Ali Saad ◽  
Zahid Rafique Butt ◽  
Zainab Khan ◽  
Saima Dastgeer ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pressure Gradient ◽  
Mitral Stenosis ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Mitral Valve Area ◽  
Mean Pressure ◽  
Procedural Outcomes ◽  
Valve Area

Objectives: To evaluate the immediate outcomes of PTMC in patients with severemitral valve stenosis. Study Design: Cross-sectional study. Setting: Ninety (90) subjects whounderwent PTMC in Cardiac Catheterization Department of CPE Institute of Cardiology. Period:June 2008 to June 2011. Methods: Patients with severe MS having mitral valve (MV) area <1.0cm2 and having morphology suitable for PTMC in the absence of regurgitation and left atrial clotwere included in this study. An increase in mitral valve area more than 50% of the baseline areawithout the development of moderate to severe MR was considered as the procedural success.Data were analyzed using SPSS V19. Pre and post procedural outcomes were measured usingpaired sample t-test. Results: There were a total number of ninety (90) patients in this study.Mean age of subjects was 28.08+9.61 years. There were more females 59 (65.5%) as comparedto only 31 (34.5%) males. There was significant increase in mitral valve area, 1.83+0.36 cm2post-PTMC versus 0.63+0.17 cm2 pre-PTMC (p-value <0.001). There was significant decreasein Peak pressure gradient (PPG) from 28.31+6.01 mmHg to 12.85+3.20 mmHg after PTMC(p-value <0.001). There were also significant reductions in mean pressure gradient andpulmonary artery systolic pressures after PTMC with p-value <0.001 and <0.001 respectively.PTMC was successful in 87 (97.7%) patients and it failed in only 3 (3.3%) patients. Conclusion:PTMC is an excellent treatment option regarding optimal outcomes and success rate in patientsof severe mitral stenosis especially when performed by experienced interventionists.

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