Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT04708080 |
| Other study ID # |
2020/182 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
July 1, 2020 |
| Est. completion date |
February 15, 2021 |
Study information
| Verified date |
February 2021 |
| Source |
Karadeniz Technical University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Elderly patients have a higher incidence of morbidity and mortality due to the interaction of
various factors such as decreased physiological reserves, concomitant comorbidities, multiple
drug use, cognitive dysfunction, and frailty. Surgical stress, pain and associated lung
complications are common problems in open heart surgeries that can affect morbidity and
mortality. With a good postoperative pain control and improved respiratory mechanics,
complications that may develop in patients can be significantly prevented, and the hospital
cost can be reduced and the workforce loss of patients can be reduced by reducing the length
of hospital stay in the intensive care unit. Thoracic epidural analgesia (TEA) is an
anesthetic analgesia method that has positive effects on many organ systems as well as
providing good pain control and is frequently used in open heart surgery. The aim of this
study is to investigate the effects of TEA on postoperative respiratory mechanics in
geriatric patients, based on analgesia levels, extubation times, length of stay in intensive
care, arterial blood gases, morbidity and mortality.
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.
