Biomedical subjects

Maja Sostaric

Publications and source records attributed to Maja Sostaric.

3 recordsLinked to original sources

PubMed2005

Incisional administration of local anesthetic provides satisfactory analgesia following port access heart surgery.

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% ropivacaine 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.

Anesthetics, Local↗

PubMed2004

Minimally invasive aortic valve replacement under thoracic epidural anesthesia in a conscious patient: case report.

Cardiopulmonary bypass and full median sternotomy have been recognized as major morbidity factors in cardiac surgery. Additional morbidity factors are general anesthesia and endotracheal intubation. Over the past several years high-thoracic epidural anesthesia (hTEA) has emerged as a potentially beneficial supplement to general anesthesia in the care of patients undergoing cardiac surgery. We report a case of ministernotomy aortic valve replacement performed with hTEA. The procedure was not converted to general anesthesia or to a conventional operation and was performed without adverse incidents. The patient was discharged from the hospital on the 2nd postoperative day. There were no complications within 30 days after surgery. This case demonstrates that thoracic epidural anesthesia without endotracheal intubation used for aortic valve replacement performed through ministernotomy is feasible. Further experience is necessary to determine the safety of this method and the effect on outcome.

Analgesia, Epidural↗

PubMed2003

Endoscopic aortic valve replacement.

During the last 8 years, many different approaches for minimally invasive aortic valve surgery have emerged. We have developed a technique that enables total endoscopic aortic valve replacement with port access, via a small right lateral thoracotomy with only soft tissue retraction and minimally invasive aortic crossclamping. The operation is performed under video guidance, since no direct eye vision is possible. We believe this is the first such operation performed in cardiac surgery and that it mak es possible broadening of indications for nonsternotomy-video-directed surgery in the future.

Adult↗