Patient satisfaction with their pain management and comfort level after open heart surgery

WOS: 000350724400002Objective The aim of this study is to determine patient satisfaction with pain management and comfort levels after undergoing open heart surgery. Design This descriptive study was performed between January 31 and April 29, 2011. Setting The study was conducted in the cardiovascular surgery clinic of Region Training-Research hospital in Erzurum, Turkey. Subjects Fifty two patients (32 males, 20 females; mean age 58.4 years; range 25 to 77 years) who had undergone open heart surgery were included in the study. Main outcome measure(s) The patient data was collected using Personal Information Form, Pain Satisfaction Surveys and General Comfort Scales at the time of discharge. The Pain Satisfaction Survey is a survey tool which was developed by the 'American Pain Society' in 1991. The General Comfort Scale was developed by Kolcaba in 1992 and its validity and reliability in a Turkish setting was tested by Kuguoglu and Karabacak in 2004. Results In this study, 61.5% of the patients underwent coronary artery bypass graft surgery, 30.7% aorta and/or mitral valve replacement and 7.7% aneurysm repair. The mean scores of pain intensity immediately after surgery, at first post-operative ambulation, at 24 hours before discharge and at discharge were 7.07+2.6, 6.71+2.7, 6.32+2.4 and 4.57+2.3, respectively. Most subjects (88.5%) reported a wait time of 15 min as the longest time they had to wait for pain medication and patient satisfaction with pain management was found to be high. The mean score of comfort level at discharge was 3.16+0.2 and there was no statistically significant difference between the comfort level and pain rating at discharge (r=-0.225, p>0.05). Conclusion It was found that pain intensity gradually decreased as patients neared hospital discharge and their overall satisfaction with the nurses' pain management was high

Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats

Background The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. Methods Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes) was applied with a latex tourniquet (remote ischemic conditioning). In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning). In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning). In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning). Results The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning). Conclusions The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemia-reperfusion injury in muscle flaps