Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2020
Observational StudyRenal Near-Infrared Spectroscopy for Assessment of Renal Oxygenation in Adults Undergoing Cardiac Surgery: A Method Validation Study.
To investigate the correlation between invasively measured renal venous oxygen saturation (SrvO2) and tissue oxygenation (rSO2) measured with near-infrared spectroscopy (NIRS) in adult patients undergoing cardiac surgery. ⋯ Renal rSO2 is correlated to and predicts SrvO2 with a small bias and acceptable agreement. Further studies are needed before renal NIRS can be used as a surrogate marker of renal oxygenation in clinical practice.
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J. Cardiothorac. Vasc. Anesth. · Dec 2020
Postoperative Nausea and Vomiting and Pain After Robotic-Assisted Mitral Valve Repair.
To determine the rate and clinical factors associated with postoperative nausea and vomiting (PONV) and severe pain after robotic-assisted mitral valve repair. ⋯ PONV and severe pain are common after robotic-assisted mitral valve repair. Peri-incisional methadone is associated with a modest decrease in the severe pain rate but without a reduction in opioid dose or hospital stay.
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J. Cardiothorac. Vasc. Anesth. · Dec 2020
Preoperative Implementation of Transverse Thoracic Muscle Plane Block and Rectus Sheath Block Combination for Pediatric Cardiac Surgery.
Systemic intravenous administration of opioids is the main treatment strategy for intraoperative and postoperative pain management in patients undergoing cardiac surgery with sternotomy. However, using lower doses of opioids may achieve the well-established benefits of the fast-track approach, with minimal opioid-related side effects. Postoperative pain is coupled with a long stay in the intensive care unit. ⋯ Herein, the authors report on a preoperative combination of TTP block and rectus sheath block (RSB) for postoperative pain management after cardiac surgery with sternotomy that addresses pain in both the chest and epigastric areas. Considering previous studies, it is presumed that preemptive analgesic effects can be expected via a combination of the TTP block and RSB, and indeed, the preemptive effect was observed in the present study's patients. In this article, the procedure and tips for combining the TTP block and RSB are introduced.
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J. Cardiothorac. Vasc. Anesth. · Dec 2020
Case ReportsAortic Root Dilation and Testosterone Use: Are They Associated?
Aortic root dilation and thoracic aortic aneurysms are relatively rare in young and healthy patient populations. However, a number of observed incidental cases regarding young males and testosterone use raises suspicion of a potential risk factor for aortic root dilation. The authors' patient, a healthy 40-year-old man with a significant history of testosterone use who developed a massively dilated aortic root, is sufficiently alarming to report. ⋯ Nevertheless, very little clinical research exists on the relationship between testosterone use and aortic root dilation and/or thoracic aortic aneurysms. Furthermore, a small number of animal studies showed a relationship between testosterone and vascular dilation, particularly the aorta. Although testosterone may play a role in the development of aortic pathologies, further research is necessary to clarify the possible relationship if cases such as these are to be prevented.