Marc Giménez-Milà1, Sebastian Videla2, David Jenkins3, Andrew A Klein4, Caroline Gerrard4, Jacinta Nalpon4, Kamen Valchanov4. 1. Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;. Electronic address: marc.gimenez@nhs.net. 2. Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain. 3. Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge, United Kingdom. 4. Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;
Abstract
OBJECTIVES: To assess postoperative pain intensity and the analgesic requirements in the postoperative period in patients undergoing sternotomy for pulmonary endarterectomy involving deep hypothermic circulatory arrest. DESIGN: Retrospective cohort study. SETTING: Single-center hospital study. PARTICIPANTS: Patients 18 years and older undergoing sternotomy for cardiac surgery between August 2012 and August 2014. INTERVENTIONS: No modification to usual clinical practice. MEASUREMENTS AND MAIN RESULTS: Intraoperative opioid and steroid administration, referral to the chronic pain unit, intensive care unit pain scores, and analgesic administration in the first 48 hours after the admission to the intensive care unit were recorded. Postoperative pain was evaluated by means of a categoric verbal scale from no pain (0) to severe pain (3); this is the routine analgesic scale used in the authors' intensive care unit. A total of 200 consecutive patients undergoing pulmonary endarterectomy (PEA group) were included in the study. No patient in the PEA group received morphine during surgery. The mean (standard deviation) postoperative pain intensity score at 24 hours was 0.30 (0.54) in the PEA group. Postoperative morphine was administered in 39% of patients. No PEA patient was referred to the chronic pain unit after hospital discharge. CONCLUSION: The total analgesic requirements and pain score of patients undergoing sternotomy for pulmonary endarterectomy with deep hypothermic circulatory arrest seemed to be low.
OBJECTIVES: To assess postoperative pain intensity and the analgesic requirements in the postoperative period in patients undergoing sternotomy for pulmonary endarterectomy involving deep hypothermic circulatory arrest. DESIGN: Retrospective cohort study. SETTING: Single-center hospital study. PARTICIPANTS: Patients 18 years and older undergoing sternotomy for cardiac surgery between August 2012 and August 2014. INTERVENTIONS: No modification to usual clinical practice. MEASUREMENTS AND MAIN RESULTS: Intraoperative opioid and steroid administration, referral to the chronic pain unit, intensive care unit pain scores, and analgesic administration in the first 48 hours after the admission to the intensive care unit were recorded. Postoperative pain was evaluated by means of a categoric verbal scale from no pain (0) to severe pain (3); this is the routine analgesic scale used in the authors' intensive care unit. A total of 200 consecutive patients undergoing pulmonary endarterectomy (PEA group) were included in the study. No patient in the PEA group received morphine during surgery. The mean (standard deviation) postoperative pain intensity score at 24 hours was 0.30 (0.54) in the PEA group. Postoperative morphine was administered in 39% of patients. No PEA patient was referred to the chronic pain unit after hospital discharge. CONCLUSION: The total analgesic requirements and pain score of patients undergoing sternotomy for pulmonary endarterectomy with deep hypothermic circulatory arrest seemed to be low.
Authors: Marc Giménez-Milà; Sebastián Videla; Natalia Pallarés; Antoni Sabaté; Jasvir Parmar; Pedro Catarino; Will Tosh; Muhammad Umar Rafiq; Jacinta Nalpon; Kamen Valchanov Journal: Medicine (Baltimore) Date: 2020-11-13 Impact factor: 1.817