Pre-Sternal Local Anaesthetic Infiltration as Adjunct to Anaesthesia accelerates Extubation of Patients in Adult Cardiac Surgery.
Pre-Sternal Local Anaesthetic Infiltration accelerates Extubation in Cardiac Surgery.
Abstract
Objective: Compare the effect of Pre-Sternal local anesthetic (LA) infiltration and systemic opioid analgesia on the early extubation in adult cardiac surgeries.
Introduction: Median sternotomy causes severe injury and alters the pulmonary functions and consequent recovery. Different methods have been used to allay the pain caused and local infiltration of anaesthetics has been documented with good results.
Material and Methods: Fifty (n=50) adult patients requiring open-heart surgeries were randomly allocated to two groups (I & II) of 25 each irrespective of gender and age. An infusion of fentanyl @1mcg/kg/hr was given to Group I patients while as in Group II, 20ml of 0.5% ropivacaine was infiltrated at the intended sternotomy site. Both groups further received 50 mcg bolus of fentanyl at the time of sternotomy retraction. Postoperatively patients were shifted to cardiac surgical intensive care unit (CSICU) and were observed for weaning and early extubation.
Results: The mean time of extubation was earlier in Group II patients at 4.24 hours after surgery with shorter time duration of postoperative ventilation as compared to 6.90 hours in Group I patients. We also observed a better postoperative pain relief as evident from their improved visual analogue scores (VAS) and better breathing pattern in Group II patients as compared to those in Group I after the patients were extubation. None of the patients of either group was re-intubated.
Conclusion: Pre-Sternal local anaesthetics infiltration of sternotomy site not only facilitates early extubation after open-heart surgery in CSICU but also improves pain scores hence also improves breathing and have less requirements for analgesics in postoperative periods.
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References
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