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A lot of drugs and not much oxygen: Is the cocktail responsible for delirium?
We read with great interest the article by Arenson and colleagues that analyzed the risk factors for postoperative delirium, with particular reference to the influence of intensive care unit environment, in a large study population undergoing cardiac surgery. In their multivariate analysis, postoperative delirium was significantly associated with preoperative (eg, age, preadmission use of benzodiazepine), intraoperative (eg, combined coronary artery bypass grafting and valve surgery), and postoperative (eg, stroke or transient ischemic attack, mechanical ventilation>24 hours, blood transfusion, postoperative renal insuffic...
Source: The Journal of Thoracic and Cardiovascular Surgery - January 6, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Francesco Pollari, Giuseppe Santarpino, Theodor Fischlein Tags: Letters to the Editor Source Type: research

Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial
Background: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. Methods: Open-label, prospective randomized controlled trial. 180 patients undergoing cardiac procedures through median sternotomy, were included in the period march 2007- August 2009. 151 patients were available for analysis. Pain was assessed with the 11-numeric rating scale (11-NRS). Results: Patients in the multimodal group demonstrated significantly lower avera...
Source: Journal of Cardiothoracic Surgery - March 20, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Sulman RafiqDaniel SteinbrüchelMichael WanscherLars AndersenAlbert NavneNikolaj LilleoerPeter Olsen Source Type: research