Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Randomized Controlled TrialThe Impact of Preoperative Combined Pectoserratus and/or Interpectoral Plane (Pectoralis Type II) Blocks on Opioid Consumption, Pain, and Overall Benefit of Analgesia in Patients Undergoing Minimally Invasive Cardiac Surgery: A Prospective, Randomized, Controlled, and Triple-blinded Trial.
Acute postoperative pain remains a major obstacle in minimally invasive cardiac surgery (MICS). Evidence of the analgesic benefit of chest wall blocks is limited. This study was designed to assess the influence of combined pectoserratus plane block plus interpectoral plane block (PSPB + IPPB) on postoperative pain and the overall benefit of analgesia compared with placebo. ⋯ Preoperative PSPB + IPPB reduced 24-hour postextubation opioid consumption, pain at extubation, and OBAS. Given its low risk and expedient placement, it could be a helpful addition to MICS protocols. Future studies should evaluate these findings in multicenter settings and further elucidate the optimal timing of block placement.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Multicenter Study Observational StudySex Differences in Chronic Postsurgical Pain after Open Thoracotomy.
To determine the incidence of chronic postsurgical pain (CPSP) in women after open thoracotomy. Secondary objectives were to compare relevant patient and procedural variables between women and men. ⋯ These findings show that the incidence of physician-diagnosed chronic postsurgical pain is higher in women than in men after surgeries involving thoracotomy. Sex and gender should be included in future clinical research on pain in surgical settings.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Effect of Deep Hypothermia (18°C) on Dioxygen Metabolism During Pulmonary Thromboendarterectomy Surgery.
The aim of this physiological pilot study was to investigate the effect of deep hypothermia on oxygen extraction (OE) and consumption (VO2) in normothermic conditions (36-37°C), and at different stages of cooling: 30°C, 25°C, and 18°C. ⋯ There were VO2 and OE decreases of more than half their baseline values at 18°C. Given that metabolic needs are essentially supplied by dissolved O2 during cooling from 30°C to 18°C, the authors suggest that PaO2 should be increased during the period of cooling and/or deep hypothermia to prevent hypoxia.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Observational StudyAssessment of Perioperative Protamine Reactions in Patients With Fish Allergies: A Retrospective Observational Study.
To retrospectively assess the incidence and severity of perioperative protamine reactions in adult patients with documented history of fish allergy. ⋯ The study findings suggest that in patients with a history of fish allergy, cross-reactivity with protamine is unlikely, as anaphylaxis and/or protamine reactions were rare in this patient population in the perioperative environment. Based on these findings, this study does not recommend avoiding protamine solely based on a history of fish allergy when heparin reversal is required during surgery.