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A multimodal analgesic approach combining bilateral sternal perfusion of local anesthetics, NSAIDs, and paracetamol is proposed as an effective and safe alternative to opioids for managing postoperative pain after cardiac surgery.
Cardiac surgery performed with median sternotomy is an important source of postoperative pain in both intensive care and surgery ward. After cardiac surgery, 30 to 75% of the patients report moderate to severe acute pain. The most intense pain localization during the first days is the sternotomy site. The most intense pain is that induced by the movements or "dynamic pain," especially those of coughing and deep breathing, and those made to turn in or get out of bed. stoperative pain causes a complex response, characterized by significant endocrine and metabolic changes that may contribute to complications, such as myocardial ischemia, arrhythmia, hyper-coagulation, pulmonary complications, delirium, or surgical wound infection. eatment of pain after cardiac surgery is a challenge for the clinician,
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Vedat Eljezi (2019) studied this question.
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