SURGERY, including PAIN CONTROL and CHEST DRAINS
BTS GUIDELINES for the insertion of a CHEST DRAIN (2003). Thorax; 58 (Suppl II): ii53 -ii59
www.brit-thoracic.org.uk/c2/uploads/PleuralDiseaseChestDrain.pdf
NICE GUIDELINES (2005) - LUNG VOLUME REDUCTION SURGERY for ADVANCED EMPHYSEMA
Ahonen J (2004) Brain injury after adult cardiac surgery. Acta Anaesth Scand, 48, 4-9
techniques to minimise brain injury from cardiac surgery
Akrofi M, Miller S (2005) A randomized comparison of three methods of analgesia for chest drain removal in postcardiac surgical patients. Anesth Analg 100, 205-9
www.anesthesia-analgesia.org/cgi/content/abstract/100/1/205
Al-Ruzzeh S, George S, Bustami M et al (2006) Effect of off-pump coronary artery bypass surgery on clinical angiographic, neurocognitive and quality of life outcomes. BMJ, 332, 1365
www.bmj.com/cgi/content/full/332/7554/1365
off-pump coronary artery bypass surgery shows better clinical outcome, shorter hospital stay, and better neurocognitive function than conventional CABG surgery using cardiopulmonary bypass.
American Society of Anesthesiologists (2002) Practice guidelines for postoperative care. Anesthesiol, 96, 742-52
Bastow MD, Rawlings J, Allison S (1983) Benefits of supplementary tube feeding after fractured neck of femur. BMJ, 287, 1589-92
extra nutrition after hip replacement leads to independent mobility 5 days earlier than controls
Barnes L (2009) Metastases to the head and neck. Head and Neck Pathology, 3, 3, 217-24
springerlink.com/content/y070778420n37843/fulltext.html
overview of locations, characteristics and prognosis
Battistelli S (2010) Heparin-induced thrombocytopenia in surgical patients. Am J Surg, 199, 1, 43-51
BTS Guidelines for the insertion of a chest drain. Thorax 2003; 58 (Suppl II): ii53 -ii59 www.brit-thoracic.org.uk/c2/uploads/PleuralDiseaseChestDrain.pdf
Cane J (2003) Cognitive dysfunction after minor surgery in the elderly. Acta Anaesth Scand, 47, 1204-8
cognitive dysfunction common in elderly people postop, but is reduced if hospitalization is avoided
Cerfolio RJ (2005) Recent advances in the treatment of air leaks. Curr Opin Pulm Med, 11, 319-23
www.co-pulmonarymedicine.com/pt/re/copulmonary/abstract.00063198-200507000-00012.htm;jsessionid=CjgeCc4OTYFLhhVmH5583YWzoI1DurVKT1L6wqkuLh75GwjGlLa0!654213914!-949856032!9001!-1
Charlson ME (2003) Care after coronary artery bypass surgery. NEJM, 348, 1456-63
complications, drugs, rehab, depression, lifestyle
Chestnut DH (2005) Efficacy and safety of epidural opioids for postoperative analgesia. Anesthesiol, 102, 221-4
www.anesthesiology.org/pt/re/anes/abstract.00000542-200501000-00031.htm;jsessionid=CfSj9ptDxLdljtcTTFwUCSlhd7K2Z0ut6TB3Me7NexZ866YC7Bxb!-1757678366!-949856031!9001!-1
epidural narcotics do not cause sympathetic depression or bladder dysfunction
Croal BL et al (2006) Relationship between postoperative cardiac troponin I levels and outcome of cardiac surgery. Circulation, 114, 1468-75
www.ncbi.nlm.nih.gov/pubmed/17000912?dopt=AbstractPlus&holding=f1000,f1000m,isrctn
troponin levels measured 24 hours after cardiac surgery predict mortality
De Arenaza DP (2010) Valvular heart disease: Preoperative 6-minute walk test adds prognostic information to Euroscore in patients undergoing aortic valve replacement. Heart, 96, 113-117
heart.bmj.com/content/96/2/113.full
six-minute walk test is safe and feasible before valve replacement, and provides functional and prognostic information
Ekman A, Lindholm M-L, Lennmarken C, Sandin R (2004) Reduction in the incidence of awareness using BIS monitoring. Acta Anaesth Scand, 48, 20-6.
incidence of awareness during surgery can be reduced by brain monitoring
El-Ansary D, Adams R, Ghandi A (2000) Musculoskeletal and neurological complications following CABG. Austr.Physiother.J, 46, 19-25
IMA leads to greater shoulder and chest wall pain than saphenous vein
El-Ansary D (2000) Sternal instability following coronary artery bypass grafting. Physiother Th Pract, 16, 27-33
Fishman A et al (2003) A randomised trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. New Eng J Med, 348, 2059-73
Fitzsimons D (2003) Patient anxiety while on a waiting list for coronary artery bypass surgery. Heart Lung, 32, 23-31
anxiety pre-op caused by chest pain, uncertainty, fear, physical incapacity, dissatisfaction with care
Fletcher SJ, Cuthbertson BH (2010) Outreach, epistemology and the evolution of critical care. Anaesthesia, 65, 2, 115-118
www3.interscience.wiley.com.ezproxy.brighton.ac.uk/cgi-bin/fulltext/123221310/HTMLSTART
postoperative oliguria may be part of the adaptive response to trauma and should be managed by watchful waiting rather than aggressive fluid resuscitation
Ghoneim MM (2000) Awareness during anesthesia. Anesthesiol, 92, 597-602
Gilbert A (1996) Anxiety: a risk factor in open heart surgery. ACPRC J, 29, 60
anxiety is related to postop complications
Gjeilo KH (2010) Chronic pain after cardiac surgery: a prospective study. Acta Anaesth Scand, 54, 1, 70-78
www3.interscience.wiley.com/journal/122545723/abstract
10% patients report chronic pain after cardiac surgery
Greif R (1999) Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiol, 91, 1246-52 (www.anesthesiology.org)
oxygen therapy can halve postop nausea and vomiting
Grief R (2000) Supplemental perioperative oxygen to reduce the incidence of surgical wound infection. New Eng.J.Med, 342, 161-7 (www.nejm.com)
80% oxygen during surgery halves the incidence of wound infection
Guest F et al (1997) A cost analysis of a treatment policy of a deliberate perioperative increase in oxygen delivery in high risk surgical patients. Int.Care Med, 23, 85-90
protocol to increase oxygen delivery reduces mortality from 22.2% to 5.7% in high risk patients
Gutt CN (2005) Prophylaxis and treatment of deep vein thrombosis in general surgery Am.J.Surg, 189, 14-22
Hausel J (2005) Randomized clinical trial of the effects of oral preoperative carbohydrates on postoperative nausea and vomiting after laparoscopic cholecystectomy. Brit J Surg, 92, 415-21
www.bjs.co.uk/bjsCda/cda/microJournalArticleDetail.do;jsessionid=11E054B22FF5164FAF1E1E6AD53F79A0?DOI=10.1002%2Fbjs.4901&issueDOI=10.1002%2Fbjs.v92%3A4&vid=2
a preoperative carbohydrate-rich drink relieves preoperative discomfort and reduces postoperative nausea and vomiting
Henry M et al (2003) BTS guidelines for the management of spontaneous pneumothorax. Thorax, 58(Suppl.11), ii39-ii52
Hillis GS (2006) Renal function and outcome from CABG: impact on mortality after 2.3-year follow up. Circulation, 113, 1056-62
www.ncbi.nlm.nih.gov/pubmed/16490816?dopt=AbstractPlus&holding=f1000,f1000m,isrctn
GFR is a powerful and independent predictor of mortality after CABG
Hyde J (2000) Reducing morbidity from chest drains. BMJ, 314, 914
Jonkers D, Elenbaas T, Terporten P (2003) Prevalence of 90-days postoperative wound infections after cardiac surgery. Eur J Cardiothorac Surg, 23, 97-102
Kehlet H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 78, 606-17
detailed description of postoperative complications
King PM (2005) The influence of an Enhanced Recovery Programme on clinical outcomes, costs and quality of life after surgery for colorectal cancer. Colorectal Dis, 8, 6, 506-13
ERP halved hospital stay
Brady M, Kinn S, Stuart P (2005) Preoperative fasting for adults to prevent perioperative complications. Cochrane Library issue 2
www.cochrane.org/cochrane/revabstr/AB004423.htm
no evidence to suggest a shortened fluid fast increases aspiration or regurgitation, in fact permitting patients to drink water preoperatively reduced gastric volumes.
Kjζrgaard S, Rees SE, Nielsen JA (2001) Modelling of hypoxaemia after gynaecological laparotomy. Acta Anaesthesiol Scand, 45, 3, 34956
early postoperative hypoxaemia presents in 4155% of patients, occurs during the first few hours (when the patient is continually monitored), and is related to anaesthesia, type of surgery and patient age.
late postoperative hypoxaemia presents in 4150% of patients after major abdominal or thoracic surgery, and occurs during, on average, the second postoperative night, with 3850% of patients having episodes of sudden and damaging desaturation below 85%; this is less likely to be noticed and if left untreated, may contribute to cardiovascular, cerebral or wound complications
Klasen J, Haas M, Graf S et al (2005) Impact on postoperative pain of long-lasting pre-emptive epidural analgesia before total hip replacement. Anaesthesia, 60, 118
www.blackwell-synergy.com/links/doi/10.1111/j.1365-2044.2004.03999.x/abs/
epidural analgesia the day before surgery reduces postop pain
Kehlet H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 78, 606-17
detailed description of postoperative complications
Kuo C-H (2009) Serious postoperative syncope. Lancet, 374, 9695, 1118
56% of postoperative MIs may manifest as hypotension, pulmonary oedema, or AF, without chest pain, especially for patients on high-dose opioids
Kvaslerud T, Hansen MV (2010) Circadian aspects of post-operative morbidity and mortality. Acta Anaesthesiol Scand, 54, 10, 115763
peak incidence of postoperative myocardial ischaemia, fatal thromboembolism and sudden unexpected death in the morning hours
Lebovitz AH (1999) Intraoperatve therapeutic suggestions during day case surgery: are there benefits for postoperative outcomes? Br J Anaesth, 82, 6, 861-6
bja.oxfordjournals.org/cgi/content/abstract/82/6/861
taped therapeutic suggestions during surgery help reduce some post-operative effects such as nausea and vomiting.
Lennmarken C (2002) Victims of awareness. Acta Anaesth.Scand, 46, 229
Leong YP (2002) Extreme value theory applied to postoperative breathing patterns. Br J Anaesth, 88, 1, 61-4
Mackenzie M, Yentis S, Woolnough M (2010) Fasting periods and dehydration before elective caesarean section. Anaesthesia, 65, 1, 99
a prolonged pre-operative fluid fast increases urine osmolarity, suggesting significant dehydration
Maharaj CH (2005) Preoperative intravenous fluid therapy decreases postoperative nausea and pain in high risk patients. Anesth Analg, 100, 675-82
www.anesthesia-analgesia.org/cgi/content/abstract/100/3/675
preoperative correction of hypovolaemia reduces postoperative nausea, vomiting and pain
Marshall MB, Deeb ME, et al. (2002). Suction versus water seal after pulmonary resection. Chest, 121, 3, 831.
www.chestjournal.org/cgi/content/full/121/3/831?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=121&firstpage=831&resourcetype=HWCIT
after lung surgery, suction is required for brief period only
Mason L, Edwards E, Moore RA, McQuay HJ (2003) Single-dose oral naproxen for acute postoperative pain: a quantitative systematic review. BMC Anesthesiology, 3, 4
www.biomedcentral.com/1471-2253/3/4/abstract
naproxen sodium is an effective analgesic in the treatment of acute postoperative pain, with a low incidence of adverse events
McConnelee LE (2009) Pre- and postcardiopulmonary rehabilitation in hospitalized patients undergoing coronary artery bypass surgery: a randomized control trial. Am J Phys Med Rehab, 88, 7, 591-592
Monk TG, Weldon BC, Garvan CW (2008) Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiol, 108(1):18-30
journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2008&issue=01000&article=00007&type=fulltext
cognitive dysfunction is common at discharge after major noncardiac surgery, but only those over 60 are at significant risk for long-term cognitive problems
patients with post-op cognitive dysfunction are at an increased risk of death in the first year after surgery.
Moore (1994) The effect of length of stay on complications. Ann.Surg, 220, 738-9.
early discharge increases complications and re-admissions
Moy ML (1999) Health-related quality of life improves following pulmonary rehabilitation and lung volume reduction surgery. Chest, 115, 383-9 (www.chestjournal.org)
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pain relief + early nutrition + early mobilisation halves time in hospital
Nygren J, Thorell A (1996) Preoperative gastric emptying. Ann.Surgery, 222, 728-34
causes and mechanism of atelectasis
Ong CK, Lirk P, Seymour RA (2005) The efficacy of preemptive analgesia for acute postoperative pain management. Anesth Analg, 100, 757-73
www.anesthesia-analgesia.org/cgi/content/abstract/100/3/757
pre-emptive analgesia by epidural analgesia, local wound infiltration or systemic nonsteroidal antiinflammatory drugs before surgery
Partsch H (2002) Bed rest versus ambulation in the initial treatment of patients with proximal deep vein thrombosis. Curr Opin Pulm Med, 8, 389-93
journals.lww.com/co-pulmonarymedicine/toc/2002/09000
a DVT is more likely to increase in size in patients confined to bed
leg compression and walking reduce edema and pain more rapidly than bed rest
Payen JF et al (2001) Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med, 29, 2258-63
www.ccmjournal.com/pt/re/ccm/abstract.00003246-200112000-00004.htm;jsessionid=Fy2CGhDdbhGDZch8tG4mTdGSkWljhjgvQzQqpDZc5yNQKPc17xKw!1299987372!-949856145!8091!-1
pain can be scored validly and reliably in sedated, mechanically ventilated patient
Poeze M (2000) Goal-oriented haemodynamic therapy. Int Care Med, 26, 635-7
review of randomised controlled trials on maximising oxygen delivery
Popping DM, Elia N, Marret E et al (2008) Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis. Arch Surg, 143, 990-99
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epidural analgesia protects against pneumonia following abdominal or thoracic surgery
Rasmussen BS, Sollid S, Rees SE (2006) Oxygenation within the first 120 h following coronary artery bypass grafting. Influence of systemic hypothermia or normothermia during cardiopulmonary bypass. Acta Anaesthesiol Scand, 50, 64-71
www.ncbi.nlm.nih.gov/pubmed/15109193?dopt=Abstract&holding=f1000,f1000m,isrctn
impaired oxygenation is prevalent and prolonged following CABG, with equal intensity whether the patient is cooled during surgery or not.
hypoxaemia is worst on average 48 hours after surgery, causing a shunt of 15%.
Reiland KE (2000) Gastrointestinal surgical patients' outcomes influenced by nutrition. AORN J, 71, 199-204
IV feeding is deficient in certain essential nutrients, trebles the incidence of pneumonia compared to enteral feeding and causes atrophy of the gut lining
Reimer-Kent J (2003) From theory to practice: preventing pain after cardiac surgery. Am J Crit Care, 12, 2
pain management plan, analgesics, time to extubation, postoperative length of stay
Sawyer RJ (2000) Peripheral nerve injuries associated with anaesthesia. Anaesthesia, 55, 980-91 + letter: vol.56 p.196
Scott IA, Lodge RS, Russell DM (2007) Evidence-based guide to perioperative medicine. Internal Med J, 37, 6, 389-401
www.blackwell-synergy.com/doi/abs/10.1111/j.1445-5994.2007.01344.x (abstract only)
systematic review updating the management of the perioperative patient
Siafakas NM (1999) Surgery and the respiratory muscles. Thorax, 54, 458-65
Slipman CW (2005) Transforaminal cervical blood patch for the treatment of post-dural puncture headache. Am J Phys Med Rehabil, 84, 76-80.
www.amjphysmedrehab.com/pt/re/ajpmr/abstract.00002060-200501000-00011.htm;jsessionid=CQcR2tKUInSeRnmpCIKWDVfvq5P8kleWPO0uLYWqtNbhVxA3eyV2!1704307452!-949856031!9001!-1
spinal headache may require a transforaminal blood patch
Sun Y, Gan TJ, Dubose JW (2008). Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. Br J Anaesth, 101, 151-160
bja.oxfordjournals.org/cgi/content/abstract/101/2/151
post-operative acupuncture helps relieve pain and compared to opioids brings less side effects.
Valle AGD (2001) Inflatable pillows as axillary support devices during surgery performed in the lateral decubitus position. Anesth Analg, 93, 1338-43
Veltkamp SC (2002) Prediction of serious complications in patients admitted to a surgical ward. Br J Surg, 89, 1, 94 (www.blackwell-science.com)
complications predictable by model using 11 variables
Warner DO (2000) Preventing postoperative pulmonary complications. Anesthesiology, 92, 1467-72
Weissman (2000) Pulmonary function after cardiac and thoracic surgery. Curr.Op.Anaesth, 13, 47-51
van Wilgen CP (2003) Shoulder complaints after neck dissection. Br J Oral Maxillofacial Surg, 41, 7-11
assessment to identify cause of post-op shoulder pain
NEW
Wiles MD, Dobson SA, Moppett IK (2010) The effect of a new topical local anaesthetic delivery system on forearm skin blood flow reactivity. Anaesthesia, 65, 2, 178-183
Wong DH (1997) Chronic obstructive pulmonary disease and postoperative pulmonary complications. Curr Opin Anaesth, 10, 254-8
Yates SL (2000) Neurological, psychological and cognitive sequelae of cardiac surgery. Curr Anaesth Crit Care, 11, 187-93
Zhao Y (2002) Atelectasis - an unusual and late complication of lung transplant. Clin Transplant, 16, 3, 233
surfactant defect may be a non-metastatic manifestation of malignancy
Zorn GL et al (2003) Pulmonary transplantation for advanced bronchioloalveolar carcinoma. J Thorac Cardiovasc Surg, 125, 45-8
video on CABG for patients
www.nhs.uk/video/pages/medialibrary.aspx?Page=2&Filter=&Id={D7206249-998D-4A4F-859A-A7D0310779E1}&Tag=Heart+and+lungs&Title=NHS+VIDEOS+|+Heart+bypass%3a+animation&Uri=video%2f2008%2fOctober%2fPages%2fAnimationheartbypass.aspx
ACPRC = Association of Chartered Physiotherapists in Respiratory Care
CABG = coronary artery bypass graft
GFR = glomerular filtration rate
NICE = National Institute for Health and Clinical Excellence
(updated 12/11/10)