title: Incisional administration of local anesthetic provides satisfactory analgesia following port access heart surgery.
abstract: OBJECTIVE
  To evaluate the new method of postoperative pain relief following port access (PA) heart surgery.
  
  
  METHODS
  Patients scheduled for PA heart surgery under cardioplegic arrest were enrolled in the study. At the end of the operation an epidural catheter was placed in the surgical wound. Analgesia was started with a bolus of 20 mL 0.75% ropivacaine through the catheter followed by 0.15% ropivacaine administered via patient control analgesia pump. Metamizol was also given to the patient every 12 hours intravenously (IV), and, in the case of inadequate analgesia, the rescue analgetic piritramid IV was used. The variables recorded were the visual analogue scale (VAS), the number of bolus applications of local anesthetic, and the number of bolus applications of rescue analgetic piritramid.
  
  
  RESULTS
  The pain control at the end of the operation was satisfactory with all patients who were extubated on the table. In the first 24 hours the mean VAS pain score was 2.5, the number of bolus applications of local anesthetic was 2.0, and the number of applications of rescue medication was 1.5. There were no wound infections related to the catheter and no complications related to local anesthetic.
  
  
  CONCLUSIONS
  The incisional administration of local anesthetic provides satisfactory pain control after PA heart surgery.
authors.affiliation: Clinical Department of Anesthesiology and Intensive Care, Univesity Medical Center, Ljubljana, Slovenia. maja.sos@siol.net
authors.forename: Maja
authors.initials: M
authors.lastname: Sostaric
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local