Scandinavian journal of thoracic and cardiovascular surgery
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Scand J Thorac Cardiovasc Surg · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialReduction of post-thoracotomy pain by cryotherapy of intercostal nerves.
In a prospective study, 144 patients undergoing thoracotomy were randomized to two groups: In 71 cases cryoanalgesia was applied intraoperatively to the intercostal nerves above and below the incision to relieve postoperative pain, and 73 (control group) received bupivacaine-adrenaline intercostal blockade at the end of the operation. The amount of administered narcotic and mild analgesics, the visual analogue pain scores, the need for further intercostal blockade and the number of postoperative bronchoscopies to clear retained secretion were significantly less in the cryoanalgesia group than in the controls. There were no late nerve complications after cryoanalgesia, which is recommended for routine use in thoracotomy.
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Scand J Thorac Cardiovasc Surg · Jan 1988
Association between bleeding and reduced red cell deformability following cardiopulmonary bypass.
In 56 patients undergoing open-heart surgery, red cell trauma during and following cardiopulmonary bypass (CPB) was monitored with a microfiltration method that estimated deformability of the cells. Red cell deformability was reduced by 38% during CPB and at a slower rate thereafter. The lowest filterability rate was reached on the second day, after which improvement began. ⋯ Following valve replacement, however, preoperative values were not regained during this period, which was attributed to continuous mechanical trauma by the artificial valves. A 50% reduction of red cell filterability from the end of CPB to 12 and 24 hours from the start of CPB was associated with heavy blood loss (greater than 1,000 ml) from drains. Reduced red cell deformability thus showed relationship with a bleeding tendency following use of CPB.
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Scand J Thorac Cardiovasc Surg · Jan 1987
The value of 99mTc macroaggregated albumin lung perfusion scanning in the prediction of postpneumonectomy function and pulmonary artery pressure.
99mTc macroaggregated albumin lung perfusion scans were performed with assessment of pulmonary hemodynamics in 14 male patients with a centrally located lung tumor, subjected to pneumonectomy. In 7 patients perfusion of the affected lung was less than one third of total perfusion. However, all tumors were resectable. ⋯ A fair but not significant correlation existed in the prediction of vital capacity (VC, r = 0.64) and total lung capacity (TLC, r = 0.71). No correlation was found between perioperative change in mean pulmonary artery pressure (MPAP) and either relative radionuclide uptake of the affected lung or predicted FEV1. So, the lung perfusion scan cannot be used in preoperative estimation of postoperative MPAP.
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Scand J Thorac Cardiovasc Surg · Jan 1987
Effect of fibrin sealant on the tensile strength of rat visceral pleura.
Post mortem studies of rat lungs showed that application of fibrin sealant augments the tensile strength of the lung/visceral pleura by approximately 100 mmHg, thus impeding air leakage.
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Scand J Thorac Cardiovasc Surg · Jan 1986
Comparative StudyIntraoperative cryolysis of intercostal nerves in thoracic surgery.
Pain is a major problem associated with thoracotomy. Intraoperative cryolysis of the intercostal nerves around the incision can essentially reduce the postoperative analgesic requirement and diminish the impairment of ventilatory capacity. To obtain maximum effect, it is recommended that the sites of drainage should also be treated with cryolysis.