Association between postoperative pain and analgesic use in minimally invasive cardiac surgery.

Shunsuke Sato, Yurie Obata, Takashi Azami, Masato Fujimoto, Kyozo Inoue, Kenji Okada
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Abstract

Background: This study aimed to investigate the effects of surgical methods on pain duration and oral analgesic administration in patients who underwent cardiac surgery using various minimally invasive methods.

Methods: We included 90 patients who underwent an anterior incision with costal cartilage transection, lateral incision without costal cartilage transection, or total endoscopic cardiac surgery using a lateral incision and no retractor. Oral analgesics were postoperatively administered upon patient request. All the patients were instructed to rate their pain during the daytime 3 and 7 days postoperatively.

Results: Between-group differences included surgical method, wound size, operation/cardiopulmonary bypass time/cardiac arrest time, and intraoperative fentanyl dose. No differences were found in sex, age, diabetes status, paravertebral block use, or blood loss. The number of postoperative days, postoperative analgesic use, and pain 3 days postoperatively demonstrated no difference. Pain ratings were most severe for the costal cartilage resection group and least severe for the total endoscopic cardiac surgery group 7 days postoperatively. Similarly, patients who underwent costal cartilage research exhibited the highest rate of analgesic use for 30 days postoperatively, whereas patients who underwent total endoscopic cardiac surgery demonstrated the lowest.

Conclusions: We revealed significant between-group differences in pain prevalence and postoperative oral analgesic administration in patients who underwent cardiac surgery relative to the minimally invasive surgical method used.

微创心脏手术中术后疼痛与镇痛药使用之间的关系。
背景本研究旨在调查使用各种微创方法进行心脏手术的患者中,手术方法对疼痛持续时间和口服镇痛药的影响:我们纳入了 90 名患者,他们分别接受了带肋软骨横断的前切口手术、不带肋软骨横断的侧切口手术或使用侧切口和无牵引器的全内窥镜心脏手术。术后应患者要求使用口服镇痛药。所有患者都被要求在术后 3 天和 7 天对白天的疼痛进行评分:结果:组间差异包括手术方法、伤口大小、手术/心肺旁路时间/心跳停止时间和术中芬太尼剂量。在性别、年龄、糖尿病状况、椎旁阻滞的使用或失血量方面未发现差异。术后天数、术后镇痛药的使用和术后 3 天的疼痛没有差异。肋软骨切除术组术后7天的疼痛评分最严重,而全内窥镜心脏手术组术后7天的疼痛评分最轻微。同样,接受肋软骨研究的患者在术后30天内使用镇痛药的比例最高,而接受全内窥镜心脏手术的患者使用镇痛药的比例最低:我们发现,相对于所使用的微创手术方法,接受心脏手术的患者在疼痛发生率和术后口服镇痛药方面存在明显的组间差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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