Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2022
Randomized Controlled TrialEffect of Volatile Anesthesia Versus Total Intravenous Anesthesia on Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial.
The purpose of this study was to evaluate the effect of volatile anesthesia and propofol-based total intravenous anesthesia (TIVA) on postoperative pulmonary complications (PPCs) among patients undergoing cardiac surgery. ⋯ In adult patients undergoing cardiac surgery with cardiopulmonary bypass, general anesthesia with a volatile anesthetic compared with propofol-based TIVA had not reduced pulmonary complications within the first 7 days after surgery.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2022
Case ReportsPerioperative Hemostatic Management of a Newborn With Hereditary Hemophilia A Undergoing Emergent Surgery for Dextro-Transposition of the Great Arteries.
Hemophilia A is an inherited bleeding disorder characterized by a lack of plasma clotting factor VIII (FVIII). In prophylaxis or during surgery, FVIII infusions are necessary to prevent bleeding. The authors describe the perioperative challenges and application of a multidisciplinary hemostatic management approach to a Caucasian male newborn, with antenatal diagnoses of moderate hemophilia A (2 IU/dL) and dextro-transposition of the great arteries requiring arterial switch surgery within the first month of life. ⋯ Successful cardiac surgery, using cardiopulmonary bypass, was performed with continuous infusion of FVIII at 5 IU/kg/h. Thirteen days after surgery, the FVIII antibody screening remained negative and continuous infusion was switched in favor of a daily intravenous bolus treatment to facilitate reconciliation to the center of origin. The authors' multidisciplinary strategy, established antenatally, allowed for successful care in this highly complex and rare situation.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2022
Bilateral PECS II Block is Associated with Decreased Opioid Consumption and Reduced Pain Scores for up to 24 hours After Minimally Invasive Repair of Pectus Excavatum (Nuss Procedure): a Retrospective Analysis.
Compared to the open surgical technique, the minimally invasive repair of pectus excavatum (MIRPE; Nuss procedure) is a thoracoscopic technique designed to minimize intraoperative tissue damage. It still causes severe postoperative pain due to the insertion and pressure of the retrosternal bar used to raise the sternum and stabilize the chest. This study aimed to identify associations between ultrasound-guided PECS-II block and postoperative analgesia after the Nuss procedure. ⋯ Bilateral PECS-II block is associated with decreased pain scores for up to 12 hours, and with decreased opioid consumption for up to 24 hours, following minimally invasive repair of pectus excavatum (Nuss procedure) in adolescents. PECS-II block in this context has not been previously described.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2022
Effectiveness and Safety of E-aminocaproic Acid in Overall and Less-Invasive Cardiac Surgeries.
To examine E-aminocaproic acid effectiveness in reducing transfusion requirements in overall and less-invasive cardiac surgery, and to assess its safety. ⋯ The reduction of postoperative red blood cell requirement observed when analyzing the overall cohort did not translate to less-invasive cardiac surgery in the authors' patient population; however, both overall and less-invasive cohorts had lower requirements for other blood components with E-aminocaproic acid. There was no association with major Society of thoracic surgeons (STS)-defined morbidity and mortality in both groups.