Abstract:
OBJECTIVE:The present study examined the feasibility and efficacy of continuous bilateral erector spinae blocks for post-sternotomy pain in pediatric cardiac surgery. DESIGN:Prospective cohort study; patients were retrospectively matched 1:2 to control patients. Conditional logistic regression was used to compare dichotomous outcomes, and generalized linear models were used for continuous measures, both accounting for clusters. SETTING:Quaternary children's hospital, university setting. PARTICIPANTS:The study comprised 10 children ages five-to-17 years undergoing elective cardiac surgery requiring cardiopulmonary bypass. INTERVENTIONS:Ultrasound-guided bilateral erector spinae blocks at the conclusion of the cardiac surgical procedure, with postoperative infusion of ropivacaine until chest tube removal. Postoperative management otherwise followed standardized guidelines. MEASUREMENTS AND MAIN RESULTS:Patient characteristics were similar in the two groups. The median time to completion of the bilateral blocks was 16.0 minutes (interquartile range [IQR] 14.8-19.3), and no major adverse events were identified. Pain scores were low in both groups. Postoperative opioid use at 48 hours, rendered as oral morphine equivalents, was significantly reduced in the patients receiving the blocks. Cluster-adjusted squared-root-transformed means ± standard error were 0.89 ± 0.06 mg/kg for patients receiving the blocks versus 1.05 ± 0.06 mg/kg for control patients (p = 0.04; raw medians 0.81 [IQR 0.41-1.04] v 1.10 [IQR 0.78-1.35] mg/kg, respectively). There were no differences in recovery metrics, length of stay, or complications. CONCLUSIONS:Bilateral erector spinae blocks were associated with a reduction in opioid use in the first 48 hours after pediatric cardiac surgery compared with a matched cohort from the enhanced recovery program. Larger studies are needed to determine whether this can result in an improvement in recovery and patient satisfaction.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Roy N,Brown ML,Parra MF,Sleeper LA,Alrayashi W,Nasr VG,Eklund SE,Cravero JP,Del Nido PJ,Brusseau Rdoi
10.1053/j.jvca.2020.10.009subject
Has Abstractpub_date
2020-10-12 00:00:00eissn
1053-0770issn
1532-8422pii
S1053-0770(20)31123-Xpub_type
杂志文章abstract:OBJECTIVES:Open cardiac surgery may cause severe postoperative pain. The authors hypothesized that patients receiving a bundle of care using continuous erector spinae plane blocks (ESPB) would have decreased perioperative opioid consumption and improved early outcome parameters compared with standard perioperative mana...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.11.021
更新日期:2019-06-01 00:00:00
abstract::Appropriate anesthesia for LVAD placement needs to incorporate an understanding of the surgical procedure and LVAD physiology, the altered physiology and pharmacology of the cardiac failure patient, and a knowledge of the interaction of anesthesia with the potent cardiac drugs used in end-stage heart failure therapy. ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:The authors aimed to assess determinants of intubation time and evaluate its impact on 30-day and 1-year postoperative survival in Surgical Treatment for Ischemic Heart Failure (STICH) trial patients. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS:A multivariable Cox proportional hazards model was used amo...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.12.038
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To examine whether a thromboxane receptor antagonist, NT-126, or a thromboxane synthase inhibitor, OKY-046, prevents circulatory changes caused by protamine reversal of heparin and to evaluate the significance of thromboxane generation in the phenomena. DESIGN:Prospective, randomized, controlled, animal stud...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2000.18449
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:To determine the feasibility, safety, and efficacy on PaO(2)/F(I)O(2) ratio of prone positioning (PP) for acute respiratory distress syndrome (ARDS) after cardiac surgery. DESIGN:Retrospective review of information entered prospectively in the authors' database. SETTING:A private community nonteaching hospi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2007.10.013
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and efficacy of ketamine in pediatric patients undergoing interventional cardiac procedures. DESIGN:A retrospective clinical study. SETTING:A single, tertiary referral center. PARTICIPANTS:Patients (n = 107) undergoing interventional cardiac procedures between July 1996 and July 1998...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(00)90053-3
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:To determine whether smoking cessation can reduce the incidence of postoperative hypoxemia (POH) after on-pump coronary artery bypass grafting (CABG) surgery. DESIGN:Prospective, single-center, observational study. SETTING:Single-center university teaching hospital. PARTICIPANTS:The study comprised 300 pa...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.05.011
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:To prospectively assess the diagnostic performance of echocardiographic measurements before spinal anesthesia in elderly patients undergoing lower limb surgery. Emphasis was placed on the dIVCmax-to-IVCCI ratio and IVCCI, where dIVCmax was the maximum diameter of inferior vena cava (IVC) at expiration and IV...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.02.032
更新日期:2019-09-01 00:00:00
abstract::Clinical manifestations of coronavirus disease 2019 in pregnant women, in contrast to previous outbreaks, seem to be similar to those of nonpregnant women. During severe acute respiratory syndrome (SARS), SARS influenza A, and Middle East respiratory syndrome outbreaks, an increased severity of disease among pregnant ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type:
doi:10.1053/j.jvca.2020.07.088
更新日期:2020-08-06 00:00:00
abstract::These cases illustrate the advantages of the laryngeal mask as compared with an endotracheal tube or oxygen face mask for selected patients undergoing therapeutic bronchoscopic procedures. The advantages include a larger internal diameter allowing easier passage of instruments, reduced work of breathing, lack of disco...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80017-5
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether or not perioperative administration of sodium bicarbonate had a preventive effect on cardiac surgery-associated acute kidney injury (CSA-AKI) as shown in randomized controlled trials. DESIGN:The authors conducted a systematic review and meta-analysis using MEDLI...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2015.03.007
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:The authors performed a meta-analysis to evaluate whether levosimendan is associated with improved survival in patients undergoing cardiac surgery. DESIGN:A meta-analysis. SETTING:Hospitals. PARTICIPANTS:A total of 440 patients from 10 randomized controlled studies were included in the analysis. INTERVEN...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2009.05.031
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:Potassium and magnesium are frequently administered after cardiac surgery to reduce the risk of atrial fibrillation (AF). The evidence for this practice is unclear. This study was designed to evaluate the relationship between serum potassium and magnesium levels and AF after cardiac surgery. DESIGN:Observat...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.10.045
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the left ventricular lusitropic effects of epinephrine versus milrinone after cardiopulmonary bypass. DESIGN:Prospective randomized study. SETTING:Single institution, university teaching hospital. PARTICIPANTS:Adult patients undergoing coronary artery bypass grafti...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2005.03.011
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To assess the association between postoperative central venous oxygen saturation (ScvO(2)) and arterial lactate with outcome after cardiac surgery. DESIGN:Prospective observational study. SETTING:University-affiliated tertiary care hospital. PARTICIPANTS:Patients after coronary artery bypass and/or valve s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.07.021
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To evaluate whether exogenous surfactant therapy may be useful in adult patients with acute lung injury or acute respiratory distress syndrome, using a meta-analysis of published clinical trials. DESIGN:A comprehensive literature search was performed to identify all randomized clinical trials examining the e...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析
doi:10.1053/j.jvca.2011.11.006
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:The purpose of the present study was to examine resource utilization in octogenarians undergoing coronary artery bypass grafting (CABG) and compare it with usage in their younger cohorts at a tertiary care heart center. The resources examined were time to extubation, packed red blood cell transfusions, intens...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.03.030
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To compare paravertebral block under thoracoscopy with wound infiltration at an early stage after video-assisted thoracic lobectomy surgery. DESIGN:A prospective, randomized, triple-blinded, placebo-controlled trial. SETTING:A single-center university hospital. PARTICIPANTS:Patients scheduled for video-ass...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2015.06.013
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the prognostic implication of changes in postoperative B-type natriuretic peptide (BNP) concentrations in patients undergoing cardiopulmonary bypass for cardiac surgery. DESIGN:A retrospective analysis of prospectively collected clinical data. SETTING:Cardiothoracic surgery and an intensive care...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.07.002
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:Experimental inflammation induces degradation of glycocalyx. The authors hypothesized that inflammation is an important determinant of glycocalyx degradation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). DESIGN:A prospective observational study. SETTING:Operation theater and inte...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.04.007
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Patients undergoing transapical cardiac procedure are a minority of cardiac surgery patients but represent a challenge for cardiac anesthesiologists because they generally are older and have more comorbidities than do open heart cardiac surgery patients. The aims of this study were to describe the anesthetic ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.10.039
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the impact of intra-aortic balloon pumping (IABP) on the comparison of simultaneous measurements of cardiac output via pulmonary arterial and transpulmonary thermodilution (PiCCO; Pulsion Medical Systems, Munich, Germany). DESIGN:Prospective. SETTINGS:University researc...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.11.020
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:Over 150,000 carotid endarterectomy (CEA) procedures are performed each year. Perioperative anesthetic management may be complex due to multiple patient and procedure-related risk factors. The authorsaimed to determine whether the use of general anesthesia (GA), when compared with regional anesthesia (RA), wo...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.08.195
更新日期:2019-04-01 00:00:00
abstract::The ASA Closed Claims Project has generated a standardized collection of case summaries of adverse anesthetic outcomes, with the objectives of identifying major areas of anesthesiologist liability and the contribution of substandard care to anesthetic injury. Seventy-six (3%) of the files in the project's current data...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(94)90608-4
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To determine the degree of hemodynamic and airway compromise in infants and children undergoing anesthesia for primary cardiac tumors. DESIGN:Retrospective study. SETTING:Tertiary-care, academic children's hospital. PARTICIPANTS:Patients <18 years old who had undergone anesthesia and surgery for resection ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.126952
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To determine whether preoperative regional cerebral oxygen saturation (rSO2) and the decrease in rSO2 during carotid clamping were predictive of the risk for neurologic complications in carotid endarterectomy and to determine the cutoff values of the studied parameters. DESIGN:Cohort, prospective, nonrandomi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章
doi:10.1053/j.jvca.2016.10.017
更新日期:2017-06-01 00:00:00
abstract::Advances in pediatric solid organ transplantation have furthered the understanding of end-organ failures and refined the strategies for perioperative management of these otherwise lethal diseases. As the donor pool expands, the number of transplantations increases and long-term survival continues to improve, more comp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(98)90205-1
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVES:Recent studies have demonstrated that perioperative myocardial ischemia, detected by electrocardiography, is a risk factor for myocardial infarction. ST-segment analyzers and hemodynamic monitors may be useful for on-line detection in perioperative and critical care environments. However, independent perform...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80230-7
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To assess the impact of regional supplemented general anesthesia (RSGEN) on regional myocardial function during abdominal aortic surgery (AAS). DESIGN:Prospective randomized study. SETTING:Single academic medical center. PARTICIPANTS:Seventy-three patients scheduled for infrarenal aortic aneursymectomy. I...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(97)90201-9
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To evaluate magnesium as a sole or adjuvant agent with currently used prophylactic drugs in suppressing postoperative atrial tachyarrhythmias (POAT) after coronary artery bypass graft (CABG) surgery. DESIGN:Single-center prospective, randomized clinical trial. SETTING:University hospital. PARTICIPANTS:Pati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/jcan.2001.21959
更新日期:2001-04-01 00:00:00