- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04708080
Effects of Thoracic Epidural Analgesia in Geriatric Patients Undergoing Open Heart Surgery
Effect of Thoracic Epidural Analgesia on Short-term Outcome and Mortality in Geriatric Patients With Open Heart Surgery
Study Overview
Status
Intervention / Treatment
Detailed Description
It has been shown that stress response suppression by providing good analgesia with local or systemic methods in the postoperative period reduces mortality and morbidity in many types of surgery. Especially the physiological changes that occur with aging, comorbid diseases and the drugs used in the treatment of these diseases, the type of surgery performed, the postoperative pain treatment and the anesthesia method chosen affect mortality and morbidity Thoracic epidural analgesia (TEA) has provided similar benefits in open heart surgery by suppressing stress response and increasing functional residual capacity with positive effects on the diaphragm, as well as providing good analgesia with thoracic sympathetic block.TEA has positive effects on postoperative pulmonary and circulatory system in selected eligible patients; It allows earlier extubation and provides excellent analgesia. It has been reported that TEA combined with general anesthesia in elective cardiac surgery offers a significant advantage compared to general anesthesia in terms of intensive care and hospital stay, improvement or morbidity. Studies have shown that TEA reduces surgical stress response, improves hemodynamic stability, and reduces the incidence of myocardial ischemia after coronary artery bypass surgery (CABG) as well as supraventricular arrhythmias in the postoperative period .
Based on these studies, the investigators determined the effects of TEA combined with general anesthesia on postoperative respiratory mechanics, analgesia levels, extubation times, length of stay in intensive care, arterial blood gases, effects on organ functions, morbidity and mortality in geriatric patients with open heart surgery in our hospital. the investigators aimed to contribute to the literature by reviewing it retrospectively.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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-
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Trabzon, Turkey, 61080
- Karadeniz Technical University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Elective patients undergoing open heart surgery
Exclusion Criteria:
- Emergency operations
- Patients whose data cannot be reached
- Patients younger than 65
- Patients whose records could not be accessed and who were excluded from the study group procedure in which they were included for any reason will not be included in the study.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Group E
patients who underwent thoracic epidural catheter for postoperative analgesia
|
A thoracic epidural catheter is routinely placed in patients undergoing open heart surgery in our hospital, at least 1 hour before heparin administration during the operation.
After standard monitoring (ECG, SpO2, NIBP) is applied to the patients in the operating room, sedoanalgesia is provided with 1-3mg of midazolam and 50-100mcg of fentanyl.
Then, by providing sterilization conditions, an epidural catheter is inserted through the T5-T6 interval with Tuohy needle.
After confirming the location of the epidural catheter, 25mg / 10ml bupivacaine is administered as a bolus and then 3ml / hour bupivacaine infusion is started from the solution prepared as 3mg / ml and continues until the 48th postoperative hour.
On the postoperative 2nd day, the catheter is removed 10-12 hours after LMWH administration and 2-4 hours after UFH, as recommended by the guidelines, paying attention to the anticoagulant administration times applied to the patients.
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Group I
Patients who cannot be applied thoracic epidural catheter for postoperative analgesia
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
the effect of thoracic epidural analgesia
Time Frame: up to 4 weeks
|
postoperative respiratory parameters
|
up to 4 weeks
|
the effect of thoracic epidural analgesia
Time Frame: postoperative period 3 day
|
Patients' sedation and analgesia levels
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postoperative period 3 day
|
the effect of thoracic epidural analgesia
Time Frame: 1 day
|
extubation times
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1 day
|
the effect of thoracic epidural analgesia
Time Frame: 1 month
|
postoperative respiratory complications
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1 month
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the effect of thoracic epidural analgesia
Time Frame: up to 4 weeks
|
lengths of ICU and hospitality stay
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up to 4 weeks
|
the effect of thoracic epidural analgesia
Time Frame: 1 year
|
mortality
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1 year
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020/182
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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