Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Aug 2005
Randomized Controlled TrialComparison of lumbar epidural tramadol and lumbar epidural morphine for pain relief after thoracotomy: a repeated-dose study.
The purpose of this study was to compare lumbar epidural morphine and lumbar epidural tramadol with respect to onset and duration of analgesia, analgesic efficacy, and drug-related side effects after muscle-sparing thoracotomy. ⋯ The study revealed that the quality of analgesia achieved with repeated doses of lumbar epidural tramadol after muscle-sparing thoracotomy is comparable to that achieved with repeated doses of lumbar epidural morphine. Compared with morphine, lumbar epidural tramadol results in less sedation and a less-pronounced decrease in oxygenation.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2005
Randomized Controlled TrialAcetaminophen decreases early post-thoracotomy ipsilateral shoulder pain in patients with thoracic epidural analgesia: a double-blind placebo-controlled study.
Despite effective epidural analgesia, up to 85% of post-thoracotomy patients complain of moderate-to-severe ipsilateral shoulder pain. This study assessed the efficacy of acetaminophen in decreasing postoperative shoulder pain after a thoracotomy. ⋯ Acetaminophen decreases post-thoracotomy ipsilateral shoulder pain when given preemptively and regularly during the first 48 hours postoperatively in patients who received thoracic epidural analgesia.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2005
Comparative StudyMajor clinical outcomes in adults undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest: quantification of organ-based perioperative outcome and detection of opportunities for perioperative intervention.
The purpose of this study was to describe clinical outcome after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA), to determine mortality and length of stay, neurologic outcome, cardiorespiratory outcome, and hemostatic and renal outcome after DHCA. ⋯ The protocol for DHCA at the authors' institution is associated with superior or equivalent perioperative outcomes to those reported in the literature. This study identified the need for further quantification of the clinical outcomes after DHCA in order to prioritize outcome-based hypothesis-driven prospective intervention in DHCA.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2005
Comparative StudyMonitoring oxygenator expiratory isoflurane concentrations and the bispectral index to guide isoflurane requirements during cardiopulmonary bypass.
The purpose of this study was to measure the changes in isoflurane requirements during the rewarming phase of cardiopulmonary bypass with moderate hypothermia. ⋯ Isoflurane requirements are reduced during hypothermic cardiopulmonary bypass. Monitoring anesthetic concentrations in the oxygenator expiratory gas may be a useful adjunct to monitoring the depth of anesthesia.