Incisional Administration of Local Anesthetic Provides Satisfactory Analgesia following Port Access Heart Surgery

Authors

  • Maja Sostaric

DOI:

https://doi.org/10.1532/HSF98.20051163

Abstract

Aim of the study: To evaluate the new method of postoperative pain relief following port access (PA) heart surgery.

Methods: Patients scheduled for PA heart surgery under cardioplegic arrest were enrolled in the study. At the end of the operation an epidural catheter was placed in the surgical wound. Analgesia was started with a bolus of 20 mL 0.75% ropivacaine through the catheter followed by 0.15% ropiva-caine administered via patient control analgesia pump. Metamizol was also given to the patient every 12 hours intravenously (IV), and, in the case of inadequate analgesia, the rescue analgetic piritramid IV was used. The variables recorded were the visual analogue scale (VAS), the number of bolus applications of local anesthetic, and the number of bolus applications of rescue analgetic piritramid.

Results: The pain control at the end of the operation was satisfactory with all patients who were extubated on the table. In the first 24 hours the mean VAS pain score was 2.5, the number of bolus applications of local anesthetic was 2.0, and the number of applications of rescue medication was 1.5. There were no wound infections related to the catheter and no complications related to local anesthetic.

Conclusion: The incisional administration of local anesthetic provides satisfactory pain control after PA heart surgery.

References

Vanermen H. 1998. What is minimally invasive cardiac surgery? J Card Surg 13(4):268-74.nBay-Nielsen M, Klarskov B, Bech K, Anderson J, Kehlet H. 1999. Levobupivacaine vs. bupivacaine as infiltration anesthesia in inguinal herniorrhaphy. Br J Anaesth 82:280-2.nVintar N, Pozlep G, Rawal N, Godec M, Rakovec S. 2002. Incisional self-administration of bupivacaine or ropivacaine provides effective analgesia after inguinal hernia repair. Can J Anaesth 49(5):481-6.nGersak B. 2003. A technique for aortic valve replacement on the beating heart with continuous retrograde coronary sinus perfusion with warm oxygenated blood. Ann Thorac Surg 76(4):1312-4.nGlower DD, Landolfo KP, Clements F, et al. Mitral valve operation via port access versus median sternotomy. Eur J Cardiothorac Surg 14(Suppl 1): S143-47.nGrossi EA, Zakow PK, Ribakove G, et al. 1999. Comparison of postoperative pain, stress response, and quality of life in port-access vs. standard sternotomy coronary bypass patients. Eur J Cardiothorac Surg(16 Suppl 2): S39-42.nPettersson N, Berggren P, Larsson M, Westman B, Hahn RG. 1999. Pain relief by wound infiltration with bupivacaine or high-dose ropivacaine after inguinal hernia repair. Reg Anesth Pain Med 24(6): 569-75.nReyes A, Vega G, Blancas R, et al. 1997. Early vs. conventional extubation after cardiac surgery with cardiopulmonary bypass. Chest 112(1):193-201.nRosenberg PH, Renkonen OV. 1985. Antimicrobial activity of bupivacaine and morphine. Anesthesiology 62(2):178-9.nRoyse CF, Royse AG, Soeding PF. 1999. Routine immediate extubationafter cardiac operation: a review of our first 100 patients. Ann Thorac Surg 68:1326-9.nErichsen CJ, Vibits H, Dahl JB, Kehlet H. 1995. Wound infiltration with ropivacaine and bupivacaine for pain after inguinal herniotomy. Acta Anaesthesiol Scand 39(1):67-70.n

Published

2005-10-27

How to Cite

Sostaric, M. (2005). Incisional Administration of Local Anesthetic Provides Satisfactory Analgesia following Port Access Heart Surgery. The Heart Surgery Forum, 8(6), E406-E408. https://doi.org/10.1532/HSF98.20051163

Issue

Section

Article