SATS 2009 Final Program - Scandinavian Association for Thoracic ...

S03:3
GABAPENTIN FOR POSTOPERATIVE PAIN MANAGEMENT AFTER CARDIAC SURGERY WITH MEDIAN
STERNOTOMY
Laursen Vibeke 1 , Tang Mariann 2 , Parvaiz Imran 3 , Hjortdal Vibeke 2
1) Aarhus University Hospital, Skejby, 2) Department of Cardiothoracic Surgery,SKS,
3) Department of Cardiacthoracic Surgery,RH, Denmark
Introduction
Cardiac surgery with sternotomy is a major surgical trauma. The surgical injury and anaestesia is followed by pain,
postoperative nausea and vomiting (PONV). Pain relief after surgery is prerequisite for moblisation and early return
to pre-surgical level. The preferred drug for postoperative pain management is opioids which are known to have
a series of side effects such as nausea, vomiting, constipation and delirium. More than one third of the patients
experience PONV after cardiac surgery. PONV is associated with longer stay in post-anaesthesia care and may
cause dehydration and prolonged recovery. Gabapentin was originally developed to treat spasticity but during the
last decade more publications and reports have documented pain relief with use of Gabapentin. Hence no studies
have evaluated Gabapentin as postoperative pain management after cardiac surgery.
Aim/hypothesis
To examine the effect of Gabapentin on postoperative pain after cardiac surgery with the hypothesis being that
Gabapentin is an effective analgesic for postoperative pain and has a opioid sparing effect.
Materials & Methods
A clinical randomized, controlled and double blind study including 64 patients scheduled for cardiac surgery with
median sternotomy. Patients were randomized to either placebo or gabapentin. The dosage of gabapentin was 1200
mg on the day of surgery and 300 mg twice a day for the following five days. Four times a day the patients did pain
assessment with Visual Analogue Score and PONV assessment.
Results
Data are being processed.
S03:4
THE EFFECT OF SOOTHING MUSIC IN RESPONSE TO STRESS AND RELAXATION DURING BED REST
AFTER OPEN-HEART SURGERY
Nilsson Ulrica 1
1) Centre of Health Care Sciences, Sweden
Music interventions have been evaluated as an appropriate intervention to reduce pain, stress and anxiety in
a number of clinical settings. A new challenge is to study if music also can influence relaxation system that
incorporates oxytocin.
Aim
To evaluate the effect of bed rest with music on stress and relaxation for patients who had undergone heart surgery
on postoperative day one.
Method
Fifty-eight patients who had randomly allocated to either music listening during bed rest or bed rest only. The music
was distributed through a music pillow connected to a MP3 player and the music, MusiCure, was soft, relaxing, and
included different melodies of 60 to 80 bpm and was played for 30 minutes with a volume of 50-60 dB. Stress and
relaxation response was assessed by s-cortisol, s-oxytocin, heart rate, respiratory rate, MAP, PaO2 , SaO2 and
subjective pain, anxiety and relaxation levels. Results: In the music group levels of oxytocin increased significantly in
contrast to the control group for which the trend over time was negative i.e. decreasing values. Subjective relaxation
levels increased significantly more and there were also a significant higher levels of PaO2. After 30 minutes there
was a significantly less s-cortisol levels in the music group. There was no difference in MAP, heart rate and SaO2
between the groups.
Conclusion
Music intervention should bee used as an integral part of the multimodal regime administered to the patients that
have undergone cardiovascular surgery.
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