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Sedation effects by dexmedetomidine versus propofol in decreasing duration of mechanical ventilation after open heart surgery.心脏直视手术后,右美托咪定与丙泊酚的镇静效果对缩短机械通气时间的影响。
Ann Card Anaesth. 2018 Jul-Sep;21(3):235-242. doi: 10.4103/aca.ACA_168_17.
2
A Review of Current Analgesic Techniques in Cardiac Surgery. Is Epidural Worth it?心脏手术当前镇痛技术综述。硬膜外麻醉值得吗?
J Cardiovasc Thorac Res. 2014;6(3):133-40. doi: 10.15171/jcvtr.2014.001. Epub 2014 Sep 30.
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Pain management after cardiac surgery: are we underestimating post sternotomy pain?心脏手术后的疼痛管理:我们是否低估了胸骨切开术后的疼痛?
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The influence of active transport systems on morphine -6-glucuronide transport in MDCKII and MDCK-PGP cells.主动转运系统对 MDCKII 和 MDCK-PGP 细胞中吗啡-6-葡糖苷酸转运的影响。
Daru. 2011;19(6):412-6.
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The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran.伊朗心脏旁路移植手术患者心脏康复对焦虑和抑郁的影响。
BMC Cardiovasc Disord. 2012 Jun 8;12:40. doi: 10.1186/1471-2261-12-40.
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Impact of anti-cancer drugs and other determinants on serum protein binding of morphine 6-glucuronide.抗癌药物和其他因素对吗啡 6-葡萄糖醛酸苷血清蛋白结合的影响。
Daru. 2010;18(2):107-13.
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Perioperative risk factors for prolonged mechanical ventilation and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass.接受体外循环冠状动脉搭桥术的女性患者中,机械通气延长和气管切开术的围手术期危险因素。
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Perioperative intravenous acetaminophen and NSAIDs.围手术期静脉内应用乙酰氨基酚和 NSAIDs。
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冠状动脉搭桥术后的镇痛与镇静:文献综述

Analgesia and sedation post-coronary artery bypass graft surgery: a review of the literature.

作者信息

Jannati Mansour, Attar Armin

机构信息

Department of Cardiovascular Surgery, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Ther Clin Risk Manag. 2019 Jun 20;15:773-781. doi: 10.2147/TCRM.S195267. eCollection 2019.

DOI:10.2147/TCRM.S195267
PMID:31417264
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6592068/
Abstract

This review aimed to study the role of analgesia and sedation after coronary artery bypass graft (CABG) surgery, regarding pain management, assisted respiration, overall postoperative health care, and hospitalization. Data were collected from Pubmed, Scopus, and Cochrane databases. The following terms were used for the search: "analgesia", "sedation", "coronary artery bypass grafting", CABG", and "opioids". Articles between the years 1988 and 2018 were evaluated. Several opioid and non-opioid analgesics used to relieve surgical pain are regarded as critical risk factors for developing pulmonary and cardiovascular complications in all kinds of thoracic surgery, especially CABG procedures. Effective pain management in post-CABG patients is largely dependent on effective pain assessment, type of sedatives and analgesics administered, and evaluation of their effects on pain relief. A significant challenge is to determine adequate amounts of administered analgesics and sedatives for postoperative CABG patients, because patients often order more sedatives and analgesics than needed. The pain management process is deemed successful when patients feel comfortable after surgery, with no negative side effects. However, postoperative pain management patterns have not included many modern methods such as patient-controlled analgesia, and postoperative pain management drugs are still limited to a restricted range of opioid and non-opioid analgesics.

摘要

本综述旨在研究冠状动脉旁路移植术(CABG)后镇痛和镇静在疼痛管理、辅助呼吸、术后整体医疗护理及住院方面的作用。数据收集自PubMed、Scopus和Cochrane数据库。搜索使用了以下术语:“镇痛”“镇静”“冠状动脉旁路移植术”“CABG”及“阿片类药物”。对1988年至2018年间的文章进行了评估。在各类胸外科手术尤其是CABG手术中,几种用于缓解手术疼痛的阿片类和非阿片类镇痛药被视为引发肺部和心血管并发症的关键危险因素。CABG术后患者的有效疼痛管理很大程度上取决于有效的疼痛评估、所使用镇静剂和镇痛药的类型以及对其镇痛效果的评估。一个重大挑战是确定CABG术后患者合适的镇痛药和镇静剂用量,因为患者常常会要求使用超出所需量的镇静剂和镇痛药。当患者术后感觉舒适且无负面副作用时,疼痛管理过程即被视为成功。然而,术后疼痛管理模式尚未纳入许多现代方法,如患者自控镇痛,且术后疼痛管理药物仍局限于有限种类的阿片类和非阿片类镇痛药。