The Thoracic and cardiovascular surgeon
-
Thorac Cardiovasc Surg · Sep 2021
Randomized Controlled Trial Comparative StudySerratus Anterior Plane Block and Intercostal Nerve Block after Thoracoscopic Surgery.
This study aimed to compare the postoperative analgesic effect between ultrasound-guided serratus anterior plane block (Group S, SAPB) and intercostal nerve block (Group I, ICNB) after single port video-assisted thoracoscopic surgery (S-VATS) in primary spontaneous pneumothorax. ⋯ In the patients who underwent S-VATS with primary spontaneous pneumothorax, the SAPB provided similar postoperative pain relief with reducing the NSAIDs consumption compared with ICNB.
-
Thorac Cardiovasc Surg · Sep 2018
Randomized Controlled Trial Multicenter Study Comparative StudyThe COSTA Study: Sternal Closure in High-Risk Patients - A Prospective Randomized Multicenter Trial.
Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. ⋯ According to these data, there is no statistically significant difference between Sternal Talon closure and wire cerclage in reducing the incidence of mediastinitis and superficial SSI after primary closure of median sternotomy in high-risk patients.
-
Thorac Cardiovasc Surg · Sep 2018
Randomized Controlled Trial Multicenter Study Comparative StudyOff-Pump Coronary Artery Bypass Grafting and Stroke-Exploratory Analysis of the GOPCABE Trial and Methodological Considerations.
Coronary artery bypass grafting (CABG) without cardiopulmonary bypass (off-pump CABG) may reduce severe adverse events including stroke. ⋯ Within recent prospective randomized multicenter trials off-pump CABG did not result in lower stroke rates. The possible intrinsic benefit of off-pump CABG may be offset by the complexity of the operative therapy as well as the multiple pathomechanisms involved in perioperative stroke.
-
Thorac Cardiovasc Surg · Sep 2018
Randomized Controlled TrialEffect of Sustained Use of Aspirin until the Time of Surgery on Outcomes following Coronary Artery Bypass Grafting: A Randomized Clinical Trial.
The topic of aspirin (acetylsalicylic acid, ASA) use in coronary artery disease patients planned for coronary artery bypass grafting during perioperative period is among the most disputed issues in cardiac surgery. We designed a study to weigh the risks and benefits of continued ASA ingestion until the time of surgery. ⋯ Sustained ASA use until the day of surgery in patients planned for elective isolated CABG can result in excessive bleeding, increased rate of reexploration, and need for more PRBC transfusion without any proven beneficial effect on reducing unfavorable postoperative outcomes. Hence, we recommend discontinuing ASA between 3 and 5 days before non-urgent CABG while keeping it on in nonelective circumstances.
-
Thorac Cardiovasc Surg · Mar 2018
Randomized Controlled TrialLocal Anesthetics delivered through Pleural Drainages improve Pain and Lung Function after Cardiac Surgery.
Pleural tubes after coronary artery bypass graft (CABG) surgery usually cause pain resulting interalia in an impact of postoperative breathing. Therefore, the influence of intrapleural lidocaine application through special double-lumen chest tubes with respect to pain relief and lung function was investigated and compared with placebo. ⋯ Intrapleural application of lidocaine is a safe and feasible method to reduce drainage-related pain and improving lung function after CABG.