Paraplegia after coronary artery bypass graft surgery: case report of a rare event.
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Biomedical subjects
Publications and source records attributed to Gayle Urquhart.
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The purpose of this study was to describe pain in adults post surgical repair for congenital heart defects. What is the intensity, sensory, and affective dimensions of pain experienced post-operatively? What is the trend in pain experienced post-operatively over time? What is the effectiveness of post-operative pain management strategies? What factors influence the dimensions of post-operative pain experienced? A descriptive prospective repeated measures design was used with 30 adult congenital heart (ACH) post-operative patients. Pain assessments using the McGill Short Form Questionnaire (MSFQ), a visual analogue pain scale (VAP), and recordings of other variables (analgesic, anxiety, activity level, non-pharmacologic intervention) were performed three times daily until hospital discharge. Mean pain intensity scores ranged from 2.44 +/- 1.31 following extubation to 1.30 +/- 0.66 on post-operative day (POD) five (scale, 0-5). Mean MSFQ scores ranged from 9.26 +/- 7.21 following extubation to 4.40 +/- 5.22 on POD five (scale, 0-45). Mean VAP scores ranged from 50.77 +/- 25.79 following extubation to 18.76 +/- 18.50 on POD five (scale, 0-100). Mean number of narcotic doses per day ranged from 4.61 +/- 2.01 to 1.88 +/- 1.98 on PODs one and five, respectively. Anxiety predicted VAP and MSFQ scores on PODs one and two; anxiety and analgesia doses predicted VAP and MSFQ scores on POD three; analgesia doses predicted MSFQ scores, analgesia and anxiety predicted VAP scores on POD four; analgesia doses and anxiety predicted VAP and MSFQ scores on POD five. No relationships were found among pain and other demographic, treatment, or clinical variables. Overall, pain was reported as mild to moderate intensity, variable in sensations, decreased over time, and adequately managed.
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The purpose of this study was to examine the difference between hemodynamic pressures and parameters obtained pre- compared to post-thermodilution CO measurements. A repeated measures within subject design was conducted with a cardiac surgical cohort. Three measures of hemodynamic pressures and parameters were determined pre- and post-CO measurements (Set 1) and repeated in 30 minutes (Set 2). The sequence was duplicated in four hours (Sets 3 and 4). Hemodynamic pressures lower pre-CO were PAS at Sets 1 and 3, and SBP, DBP, and MAP at Set 3. Hemodynamic parameters lower pre-CO were PVRI at Set 1 and SVRI at Set 3. These pre-post CO differences did not vary by greater than 10%. As the CO injectate volume had minimal effect, hemodynamic pressures may be obtained pre- or post-CO to derive hemodynamic parameters.
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