Lajšanje pooperativne bolečine po endoskopskih operacijah na srcu
Postoperative pain relief after endoscopic cardiac surgery

slovenian

2007

volume 12, issue 28

heart    therapy 

Slovensko zdravniško društvo, Združenje za endoskopsko kirurgijo

Background. Endoscopic mitral and tricuspid valve repair, endoscopic surgery for atrial septum defect, and endoscopic removal of cardiac tumours are performed through a 3 - 4-cm incision in the left hemithorax. In addition, smaller incisions of only 0.5 cm are used for inserting catheters and canulas into the superior and inferior caval veins and aorta. In these surgical procedures postoperative pain relief can be provided by administering a local anaesthetic through a catheter placed in the surgical wound.Patients and methods. Out of the 104 patients undergoing endoscopic cardiac surgery, 78 operating room-extubated patients were enrolled into the study. At the end of the procedure, a multihole epidural catheter was placed between the muscle fascia and subcutaneous tissues all along the wound for administration of either ropivacaine (R group) or bupivacaine (B group). The intensity of pain was assessed immediately upon extubation and over the next 24 hours in 4-hour intervals using the visual analogue scale (VAS). If the VAS pain score was greater than 3, a bolus of local anaesthetic was given through the catheter, or a bolus of the opioid analgetic piritramide was administered into the vein.We compared the mean VAS scores at extubation and in the first 24 hours, and the mean number of local anaesthetic and opioid boluses in the first 24 hours in groups R and B. Possible catheter-induced complications were recorded.

16.09.2009