Saha Sanjoy Kumar, Ranjan Redoy, Adhikary Asit Baran
Bangladesh University of Professionals Dhaka Bangladesh.
Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh.
Health Sci Rep. 2022 Aug 10;5(5):e774. doi: 10.1002/hsr2.774. eCollection 2022 Sep.
Surgical trauma initiates changes in central and peripheral nervous systems that need to be treated therapeutically to facilitate postoperative pain. The quality of postoperative analgesia is expected to affect clinical outcomes positively. Albeit optimal pain relief following cardiac surgery is often complex, researchers have tried to explore several techniques other than conventional ones during the last decade to find a unique analgesic method for postcardiac surgical patients. This study aims to find a unique analgesic approach that maximizes patient satisfaction after off-pump coronary artery bypass graft (OPCABG) surgery.
The current study will compare the analgesic effect of upper thoracic epidural analgesia (TEA) with conventional analgesia after OPCAB graft surgery. For this, we will use a Quasi-experimental study design. Patients admitted for coronary artery bypass graft (CABG) surgery will be assigned into two groups. The control group (conventional) will receive intravenous opioids and nonsteroidal anti-inflammatory medications, and the study (case) group (TEA) will receive Inj. Bupivacaine 0.25% as an infusion through the epidural catheter. Physiologic parameters like hemodynamic and respiratory variables and pain scores will be recorded in predesigned format periodically.
We expect to analyze a total of 130 consecutive off-pump CABG surgery patients in Group A (Case, 65 patients) and Group B (Control, 65 patients). Study variables will be the visual analog scale score, hemodynamic parameters (heart rate, mean arterial pressure, and respiratory parameters (respiratory rate, PaO, PaCO, PEFR, FEV). After data collection, the result will be analyzed and published in the public domain and in journals.
We expect thoracic epidural analgesia with local anesthetics will be a reliable postoperative analgesic option.
手术创伤会引发中枢和外周神经系统的变化，需要进行治疗干预以缓解术后疼痛。术后镇痛的质量有望对临床结局产生积极影响。尽管心脏手术后实现最佳疼痛缓解往往较为复杂，但在过去十年中，研究人员一直在尝试探索传统方法以外的多种技术，以寻找针对心脏手术后患者的独特镇痛方法。本研究旨在找到一种独特的镇痛方法，使非体外循环冠状动脉搭桥术（OPCABG）后的患者满意度最大化。
本研究将比较非体外循环冠状动脉搭桥术（OPCABG）后上胸段硬膜外镇痛（TEA）与传统镇痛的效果。为此，我们将采用准实验研究设计。接受冠状动脉搭桥术（CABG）的患者将被分为两组。对照组（传统组）将接受静脉注射阿片类药物和非甾体类抗炎药物，研究组（病例组）（TEA组）将通过硬膜外导管输注0.25%的布比卡因注射液。将定期以预先设计的格式记录血流动力学和呼吸变量等生理参数以及疼痛评分。
我们预计总共分析130例连续的非体外循环冠状动脉搭桥术患者，A组（病例组，65例患者）和B组（对照组，65例患者）。研究变量将包括视觉模拟量表评分、血流动力学参数（心率、平均动脉压）和呼吸参数（呼吸频率、PaO、PaCO、呼气峰流速、第一秒用力呼气容积）。数据收集后，结果将在公共领域和期刊上进行分析和发表。
我们预计局部麻醉药的胸段硬膜外镇痛将是一种可靠的术后镇痛选择。
