Annals of cardiac anaesthesia
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OBJECTIVE platelet function assessment after cardiac surgery can predict postoperative blood loss, guide transfusion requirements and discriminate the need for surgical re-exploration. We conducted this study to assess the predictive value of point-of-care testing platelet function using the Multiplate® device. ⋯ Peri-operative platelet functional assessment with Multiplate® was the strongest predictor for bleeding and transfusion requirements in patients on anti-platelet therapy until the time of surgery.
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Pregnancy in presence of severe aortic stenosis (AS) causes worsening of symptoms needing further intervention. In the advanced stages of pregnancy, some patients may even require aortic valve replacement (AVR) and cesarean delivery in the same sitting. ⋯ We describe successful anesthetic management for LSCS with AVR in a >33 week gravida with severe AS and congestive heart failure. We avoided opioids till delivery of the baby AVR; the delivered neonate showed a normal APGAR score.
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Randomized Controlled Trial Comparative Study
Efficacy of tranexamic acid as compared to aprotinin in open heart surgery in children.
Coagulopathy is a major issue in children undergoing high-risk pediatric cardiac surgery. Use of anti-fibrinolytics is well documented in adults, but recently there are questions raised about safety and effectiveness of their use on routine use. Tranexamic acid is a potent anti-fibrinolytic, but its role is not fully understood in children. This study aims to study the benefits tranexamic acid in controlling postoperative bleeding in pediatric cardiac surgical patients. ⋯ Anti-fibrinolytics have a definitive role in high-risk children who undergo open-heart surgery. Tranexamic acid is as equally effective as aprotinin with no additional increase in morbidity or mortality.
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Randomized Controlled Trial
The analgesic efficacy of continuous presternal bupivacaine infusion through a single catheter after cardiac surgery.
Median sternotomy, sternal spreading, and sternal wiring are the main causes of pain during the early recovery phase following cardiac surgery. ⋯ Continuous presternal bupivacaine infusion has resulted in better postoperative analgesia, reduction in morphine requirements, shorter time to extubation, and better postoperative respiratory parameters than the control group.