• Maja Sostaric, Borut Gersak, and Vesna Novak-Jankovic.
• Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre, Ljubljana, Slovenia. maja.sos@siol.net
• Heart Surg Forum. 2010 Apr 1;13(2):E96-E100.

BackgroundTo avoid large dose opioids, the authors investigated an alternative method for postoperative pain relief after Port Access cardiac surgery.MethodsOut of 104 patients who underwent Port Access heart surgery, 78 patients who were extubated in the operating room were enrolled in the retrospective study. The standardized fast track cardiac anesthesia was used for all patients, and the catheter was placed in the surgical wound at the end of the operation. Analgesia was started with a bolus of bupivacaine (B group) or ropivacaine (R group) through the catheter and followed by continuous infusion of local anesthetic. The variables recorded were visual analogue scale (VAS) at extubation and during the first 24 hours, additional requirements of local anesthetic (LA), and opioid analgetic. Possible complications that could be connected with the catheter in the wound or with the administration of LA were recorded as well.ResultsThere was no statistical difference between the R and B groups in mean pain score at extubation and in the first 24 hours. The groups were also comparable concerning the need for bolus application of the LA and opioid analgetic. The microbiological analysis of 9 randomly chosen catheter tips from both groups was sterile.ConclusionBoth local anesthetics, ropivacaine and bupivacaine, are equally effective for pain relief after Port Access cardiac surgery. The catheter in surgical incision and application of LA through it does not increase the risk for wound infection and does not interfere with wound healing.

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