Save
BILATERAL STERNAL INFUSION OF ROPIVACAINE AND LENGTH OF STAY IN ICU AFTER CARDIAC SURGERY WITH INCREASED RESPIRATORY RISK. A RANDOMISED CONTROLLED TRIAL
Author(s): ,
Eljezi, V.*
Affiliations:
CHU CLERMONT-FERRAND, Médecine Périoperatoire, CLERMONT-FERRAND, France
,
Imhoff, E.
Affiliations:
CHU CLERMONT-FERRAND, Médecine Périoperatoire, CLERMONT-FERRAND, France
,
Bourdeaux, D.
Affiliations:
CHU CLERMONT-FERRAND, Pharmacie Centrale, CLERMONT-FERRAND, France
,
Pereira, B.
Affiliations:
CHU CLERMONT-FERRAND, Direction de la Recherche Clinique et des Innovations, CLERMONT-FERRAND, France
,
Farhat, M.
Affiliations:
CHU CLERMONT-FERRAND, Pôle Cardiologie- Chirurgie Cardio-Vasculaire, CLERMONT-FERRAND, France
,
Schoeffler , P.
Affiliations:
CHU CLERMONT-FERRAND, Médecine Périoperatoire, CLERMONT-FERRAND, France
,
Azarnoush, K.
Affiliations:
CHU CLERMONT-FERRAND, Pôle Cardiologie- Chirurgie Cardio-Vasculaire, CLERMONT-FERRAND, France
Christian, D.
Affiliations:
CHU CLERMONT-FERRAND, Direction de la Recherche Clinique et des Innovations, CLERMONT-FERRAND, France
ESRA Academy. Eljezi V. Sep 15, 2017; 196131
Vedat Eljezi
Vedat Eljezi
Login now to access Regular content available to all registered users.

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.


Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

The continuous bilateral infusion of a local anaesthetic solution around the sternotomy wound (bilateral sternal) is an innovative technique for reducing pain after sternotomy. The aim was to assess the effects of the technique on the need for intensive care in cardiac patients at increased risk of respiratory complications. 

Methods:

Randomised, observer-blind controlled trial. 120 adults patients scheduled for open-heart surgery with one of the following conditions: age more than 75 years, BMI>30kg m2, chronic obstructive pulmonary disease, active smoking habit, were included. The bilateral sternal infusion of 0.2% ropivacaine (3ml h-1 through each catheter; ‘intervention’ group), was compared with standardised care (‘control’ group). Analgesia was provided with paracetamol and self-administered intravenous morphine. The main outcome measure was the length of time to readiness for discharge from ICU, blindly assessed by a committee of experts. 

Results:

No effect was found between groups for the primary outcome (P=0.680, intention to treat); the median values were 42.4 and 37.7h, respectively for the control and intervention groups (P=0.873). Similar nonsignificant trends were noted for other postoperative delays. Significant effects favouring the intervention were noted for dynamic pain, patient satisfaction, occurrence of nausea and vomiting, occurrence of delirium or mental confusion and occurrence of pulmonary complications. In 12 patients, although no symptoms actually occurred, the total ropivacaine plasma level exceeded the lowest value for which neurological symptoms have been observed in healthy volunteers.
 

Conclusions:

Because of a small size effect, and despite significant analgesic effects, this strategy failed to reduce the time spent in ICU. 

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings