Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2005
Randomized Controlled Trial Comparative StudyIntravenous acetaminophen reduced the use of opioids compared with oral administration after coronary artery bypass grafting.
The purpose of this study was to evaluate if intravenous acetaminophen compared to oral administration reduced the consumption of opioids and their side effects without an increase in pain during the stay in the intensive care unit (ICU). ⋯ Intravenous acetaminophen had a limited opioid-sparing effect when compared with oral administration after coronary artery bypass graft surgery. The opioid-sparing effect was not accompanied by any reduction in the incidence of PONV. The clinical significance of the opioid-sparing effect could therefore be questioned.
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Levosimendan is a new calcium sensitizer with inodilatory properties. There is growing clinical experience with levosimendan given to cardiac surgical patients. The aim of this report was to evaluate the effects of perioperative use of levosimendan in surgical patients with high perioperative risk, compromised left ventricular (LV) function, or difficulties in weaning from cardiopulmonary bypass (CPB). ⋯ Levosimendan can be used for postoperative rescue therapy for patients difficult to wean from CPB. Also, elective preoperative initiation of levosimendan seems applicable to patients with high perioperative risk or compromised LV function.