Abstract:
:A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether gabapentin, a commonly prescribed neuropathic analgesic and anticonvulsant, is safe and beneficial in patients with post-thoracotomy pain following thoracic surgery. Seventeen papers were identified using the search described below, and five papers presented the best evidence to reach conclusions regarding the issues of interest for this review. Side effects and complications as well as evidence of benefit, typically using various pain-scoring systems, were included in the assessment. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the papers are tabulated. The systematic review of two randomized controlled trials (RCTs) demonstrated that the use of a single dose gabapentin does not reduce pain scores or the need for epidural or morphine immediately in hospital following thoracic surgery. One double-blinded RCT used multiple doses of gabapentin perioperatively and showed that oral gabapentin administered preoperatively and during the first 2 days postoperatively, in conjunction with patient controlled analgesia morphine, provides effective analgesia in thoracic surgery with a consequent improvement in postoperative pulmonary function and less morphine consumption. One prospective clinical study comparing a 2-month course of gabapentin with naproxen sodium for chronic post thoracotomy pain following surgery showed significant improvement in both the visual analogue scale (VAS) score and the Leeds assessment of neuropathic symptoms and signs (LANSS) at 60 days in the gabapentin (P = 0.001). One prospective study of out-patients with chronic pain (>4 weeks since thoracotomy performed) suggested that gabapentin is effective, safe and well tolerated when used for persistent postoperative and post-traumatic pain in thoracic surgery patients. We conclude that there is no evidence to support the role of a single preoperative oral dose of gabapentin in reducing pain scores or opioid consumption following thoracic surgery. Multiple dosing regimens may be beneficial in reducing acute and chronic pain; however, more robust randomized control studies are needed.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Zakkar M,Frazer S,Hunt Idoi
10.1093/icvts/ivt301subject
Has Abstractpub_date
2013-10-01 00:00:00pages
716-9issue
4eissn
1569-9293issn
1569-9285pii
ivt301journal_volume
17pub_type
杂志文章,评审abstract::Platypnea-orthodeoxia syndrome is a rare condition characterized by hypoxaemia in the upright position and arterial hypoxaemia induced by the upright position, and the syndrome is relieved by recumbency. We encountered a cerebral infarction patient who presented with low SpO(2) levels in the upright position. The pati...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs105
更新日期:2012-07-01 00:00:00
abstract::The lymphatic drainage of solid organ tumors crosses through the lymph nodes (LNs) whose tumoral involvement may still be considered as local disease. Concerning lung cancer, LN involvement may be intrapulmonary (N1), and mediastinal and/or extra-thoracic. More than 30 years ago, mediastinal involved LNs were all cons...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1510/icvts.2010.236349
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:Aortic valve construction using pericardial tissue has been known since the late 1960s. The procedure was re-introduced by Ozaki in 2010 and is currently used to treat specific aortic valve diseases. The exact sizing of the neo-cusps and the insertion of the commissures remain the keys to success when perfor...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy230
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1093/icvts/ivz153
更新日期:2019-11-01 00:00:00
abstract::False aortic aneurysm is an uncommon complication after oesophageal perforation and results in a high rate of mortality. A 63-year-old patient presented with acute chest pain. Biochemical tests (cardiac enzymes) and electrocardiogram were normal. A thoracic and abdominal CT scan was performed, and showed a foreign bod...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs385
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:Because of the high prevalence of psychological disorders among ventricular assist device patients, mental health support is consensually recommended. No study as yet has provided an overview of recommended and reported mental health interventions. This article presents the results of a scoping review on the...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivy125
更新日期:2018-12-01 00:00:00
abstract::Left ventricular free wall rupture (LVFWR) is still an uncommon catastrophic complication after acute myocardial infarction (MI), and it is one of the most frequent causes of sudden cardiac death. Immediate surgical repair is the treatment of choice. When LVFWR presents acutely with tamponade and cardiogenic shock in ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.096883
更新日期:2005-02-01 00:00:00
abstract::Primary or essential hyperhidrosis is a disorder characterized by excessive sweating beyond physiological needs. It is a common disease (with an incidence of up to 2.8%) that causes intense discomfort for patients. Video-assisted thoracoscopic bilateral sympathectomy is an effective surgical treatment with high succes...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.252189
更新日期:2011-02-01 00:00:00
abstract::Atrial septal defect (ASD) is a common congenital cardiac anomaly. Even though surgery is the gold standard, percutaneous device closure is gaining popularity because of the short learning curve, cosmetic advantage and relative safety. The long-term implications are open to question. We report here two cases where sur...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.165647
更新日期:2008-02-01 00:00:00
abstract::The surgical approach to esophagectomy is variable. A number of factors are considered when determining the optimal approach to esophagectomy: location and extent of disease, fibrosis, additional patient factors and surgeon preference. One of the disadvantages to some approaches is the need for a change in position, w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.240853
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:Although deep hypothermic circulatory arrest (HCA) is routinely used to interrupt normal perfusion of the brain and prevent subsequent cerebral ischemic injury during cardiac surgery, it is associated with various forms of neurologic disturbances. Neurologic sequelae after prolonged HCA include motor, memory...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.112813
更新日期:2005-12-01 00:00:00
abstract::The re-entries are still a problem for the endovascular treatment of aortic dissections. A 60-year-old man was treated for an abdominal aortic dissection using aortic monoiliac endograft until the left iliac external artery and a femoro-femoral bypass with occlusion of the right common iliac artery and the left hypoga...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.195164
更新日期:2009-03-01 00:00:00
abstract::We herein report an emergency technique of composite Bentall operation using a fast release valve. The technique was successfully performed in 2 emergency cases after failed supracoronary ascending aortic replacement in acute Type A aortic dissection. The speed and ease of execution are the main advantages of the proc...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx435
更新日期:2018-06-01 00:00:00
abstract::The nasogastric tube is used extensively in medical practice. However, this innocent-looking tube can at times cause unexpected complications especially in patients with preexisting risk factors. A 25-year-old male was referred to our hospital with a blocked and impacted nasogastric tube which had been inserted to mai...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.157065
更新日期:2007-08-01 00:00:00
abstract::To investigate the effects on cerebral perfusion by experimental venous congestion of the superior vena cava (SVC) during bicaval cardiopulmonary bypass (CPB) at 34 °C, pigs were subjected to SVC obstruction at levels of 75%, 50%, 25% and 0% of baseline SVC flow at two arterial flow levels (low, LQ, high, HQ). The cer...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.238535
更新日期:2010-11-01 00:00:00
abstract::Acute endocarditis complicated by aortic valve regurgitation is an uncommon finding in adults with surgical untreated tetralogy of Fallot (TOF). The hemodynamic consequences for both, the right and left ventricles, are significant. However, the right ventricle may be in a disastrous situation, since a compromised righ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/j.icvts.2004.01.009
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:Bowel ischaemia following cardiac surgery is associated with a high postoperative mortality. No scoring system exists as yet to predict this complication following surgery. In addition, the long-term survival is not known. We sought to evaluate in-hospital outcomes and long-term outcomes in bowel ischaemia f...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv148
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:Here we aim to describe in detail the logical procedure and philosophical approach to establish a minimally access aortic valve replacement programme in the current era. METHODS:A real example of a National Health Service Trust in the United Kingdom has been described in a step-wise manner. RESULTS:The out...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivv279
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:Cervical mediastinoscopy may become essential in patients with pathological lymph nodes at mediastinum after laryngectomy. However, having had a previous tracheostomy has been reported to be a contraindication for cervical mediastinoscopy. METHODS:Between January 2010 and December 2017, cervical mediastinos...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz178
更新日期:2019-11-01 00:00:00
abstract::Results of surgical repair of atrioventricular septal defect (AVSD), both partial (PAVSD) and complete (CAVSD), have improved. However, reoperation is not uncommon. This report describes our experience in 59 patients who underwent reoperation after AVSD repair, between 1977 and 2008. Thirty-one patients had a PAVSD, 2...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.195180
更新日期:2009-07-01 00:00:00
abstract::Infective endocarditis (IE) and surgical procedures related to cardiac surgery are accompanied by inflammatory responses that may alter production of oxidants by phagocytes. This study evaluates luminol enhanced whole blood chemiluminescence (LBCL) as a measure of oxidative production by circulating phagocytes in 26 I...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.183285
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:Superior vena cava obstruction (SVCO) due to mitotic diseases is a serious condition with significant morbidity and mortality. The aim of this study was to examine the follow-up data and demographics of patients with SVCO admitted to the Department of Surgery, Queen Mary Hospital, over a 14-year period. MET...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs562
更新日期:2013-04-01 00:00:00
abstract::A best evidence topic was written according to a structured protocol. The question addressed was whether embolization is superior to surveillance for a type II endoleak associated with a static sac size post-endovascular abdominal aortic aneurysm repair (EVAR). Four hundred and sixty-one papers were identified, of whi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs201
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Optimal management of patients with combined coronary and carotid artery disease remains controversial. This study analyzed the outcomes between simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) vs. isolated CABG. METHODS:We reviewed the early and late follow-up data of 412...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.114678
更新日期:2006-04-01 00:00:00
abstract::Sternal wound infections occur with an incidence between 0.4 and 5% in the adult as well as the pediatric population. However, in contrast to the adults, established treatment options do not exist in the pediatric population. We evaluated our preliminary results with 3 neonates, respectively, small infants (mean age 2...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.122424
更新日期:2006-06-01 00:00:00
abstract::Drug eluting stents (DESs) reduce the incidence of restenosis after percutaneous coronary intervention (PCI) and have been predicted to decrease the number of patients referred for coronary artery bypass grafting (CABG). We studied about the impact of DESs on CABG. We compared our isolated CABG patients over two years...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.159798
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVES:Surgical ventricular reconstruction has been used to treat ischaemic cardiomyopathy with large akinetic or dyskinetic areas. However, application of this approach requires a sternotomy, cardiopulmonary bypass and a left ventriculotomy. This study assessed the feasibility and efficacy of minimally invasive, o...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt387
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:The anti-fibrillatory effect of potassium is well recognized from experimental models. There have, however, been very few clinical reports on the use of potassium to convert ventricular fibrillation (VF) after cardioplegic arrest. METHODS:In total, 8465 adult patients undergoing cardiac operations on cardio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs455
更新日期:2013-02-01 00:00:00
abstract::To determine whether coronary artery bypass grafting (CABG) with complete revascularization improves survival in patients with multivessel disease (MVD) over CABG with incomplete revascularization, we performed a meta-analysis of adjusted (but not unadjusted) risk estimates from observational studies. Databases includ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1093/icvts/ivu012
更新日期:2014-05-01 00:00:00
abstract::This retrospective study investigated whether withdrawal of aprotinin from combined low-dose aprotinin/tranexamic acid (TXA) antifibrinolytic therapy altered postoperative blood loss and transfusion requirements in patients undergoing cardiothoracic surgery employing cardiopulmonary bypass (CPB). The study included da...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.250936
更新日期:2011-02-01 00:00:00