The heart surgery forum
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The heart surgery forum · Oct 2009
Randomized Controlled Trial Comparative StudyWhich is first: left anterior descending artery anastomosis or right coronary artery anastomosis in off-pump coronary artery bypass grafting?
The sequence of the distal anastomosis for revascularization in off-pump coronary artery bypass grafting (OPCABG) surgery is under debate. The hypothesis in this study was that an analysis of cardiac markers would reveal that anastomosing the left anterior descending coronary artery (LAD) before the right coronary artery (RCA) would decrease myocardial damage in OPCABG surgery for 2-vessel disease. ⋯ Anastomosis to the LAD first in OPCABG surgery led to a slight reduction in myocardial enzyme release against the occlusion of the target vessels during anastomoses in patients with RCA and LAD stenoses.
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The heart surgery forum · Oct 2009
Randomized Controlled TrialComparison of continuous and intermittent transcutaneous electrical nerve stimulation in postoperative pain management after coronary artery bypass grafting: a randomized, placebo-controlled prospective study.
We compared the effectiveness of continuous transcutaneous electrical nerve stimulation (TENS) and intermittent TENS in the management of pain after coronary artery bypass grafting (CABG). ⋯ CTENS and ITENS after median sternotomy for CABG decreased pain and reduced narcotic requirements more than in the PTENS and control treatments during first postoperative 24 hours. Neither CTENS nor ITENS is superior to the other in decreasing pain; however, CTENS leads to a greater reduction in the narcotic requirement than ITENS.