The effects of lavandula aromatherapy on pain relief after coronary artery bypass graft surgery: A randomized clinical trial.

BACKGROUND AND AIMS: Coronary artery bypass graft surgery (CABG) is a primary treatment in coronary artery disease (CAD). Patients experience pain after CABG. Pain may increase postoperative complications and decrease quality of life (QoL). This study aims to determine the lavandula aromatherapy effect on patients' pain after CABG. METHODS: 98 patients undergoing CABG were randomly assigned to intervention and placebo groups. The intervention group inhaled 5-drops of 20 % lavandula essential oil (LEO) and the placebo group was exposed to 5-drop of distilled water. LEO or distilled water were dropped into a sterile gauze converted to the form of a necklace. The subjects wore necklace for three consecutive days and intervention was performed each 24 h. The pain intensity, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before each intervention and 30 min after it. Also, the mean analgesic intake was recorded. SPSS version 16 was used to analyze the data. RESULTS: The mean pain score measured in the intervention group showed a more decrease than that obtained in the placebo group after the first and second interventions. Additionally, the mean pain score in the intervention group demonstrated a significant decrease than the placebo group after the second intervention (P=0.008). Moreover, mean SBP after the second intervention (P=0.046) and mean DBP after the first intervention (P=0.029) revealed a significant difference between two groups. Moreover, the intervention group received less analgesic than the placebo group. CONCLUSIONS: Lavandula aromatherapy can reduce pain and received analgesic dose after CABG.

Effect of Interposed Abdominal Compression on Cardiopulmonary Resuscitation Outcomes; a Randomized Clinical Trial.

Introduction: Standard cardiopulmonary resuscitation (STD-CPR) is successful in only 10-15% of cases in emergency department (ED). This study aimed to determine the effect of interposed abdominal compression (IAC) during resuscitation on outcomes of ED cardiac arrests. Methods: In this randomized clinical trial study, non-trauma patients aged 18-85 years, patients with in-hospital cardiac arrest hospitalized in the ED were randomly assigned into two either STD-CPR or IAC-CPR group on a 1:1 basis and using computer-generated random numbers. Participants in the intervention group, received abdominal compression during the diastole phase of STD-CPR. The rate of return of spontaneous circulation (ROSC), heart rate (HR), respiratory rate (RR), arterial blood gas (ABG) indicators, and survival rate were compared between the two groups. Results: Ninety patients were enrolled (45 in each group). There were no differences between the two groups regarding age (p = 0.76), sex (p = 0.39), employment status (p = 0.62) and Charlson comorbidity scale (p = 0.46). Abdominal compression had a positive effect on heart rate (p < 0.001), mean arterial pressure (p = 0.003), arterial blood oxygen pressure (p = 0.001), and arterial blood carbon dioxide pressure (p = 0.001) as well as a negative effect on arterial blood oxygen saturation (p = 0.029) 30 minutes after resuscitation. Out of the 90 CPR cases, 8 (17.7%) cases in intervention group and 8 (17.7%) cases in control group were successful, among which all of the 8 patients in the intervention group and 5 of the patients in the control group had been discharged from hospital without any complications. Conclusion: The results showed that abdominal compression during CPR can improve resuscitation outcomes in patients with cardiac arrest. Therefore, in order to use this technique, further research is recommended.

Endotracheal Tube Duration in Elderly Patients after the Coronary Artery Bypass Grafting Surgery.

BACKGROUND: In elderly patients, the management of the endotracheal tube after coronary artery bypass graft (CABG) can be challenging because they often have complex comorbidities. This study was done to determine endotracheal tube duration in elderly patients after CABG. MATERIALS AND METHODS: This retrospective study was conducted on 397 patients aged over 65 years under mechanical ventilation after CABG. Patients in two groups of endotracheal tube duration of less than 8 h and more than 8 h were compared. Medical records were used for data gathering. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis test, and logistic regression model were used for data analysis. RESULTS: Endotracheal tube duration was 9.9± 5.89 h in elderly patients. According to the results of the Mann-Whitney U test, there was a significant difference between the two groups in terms of the history of smoking (p = 0.023), history of diabetes (p= 0.062), left ventricular ejection fraction (p= 0.028), and type of operation in terms of emergency and non-emergency (p= 0.069). The logistic regression model showed predictive variables of the endotracheal tube duration after CABG in elderly patients over 65 years, including the history of smoking (1.179- 4.543, CI: 95%, ß=0.839, and, p=0.015), history of myocardial infarction (0.188- 1.019, CI: 95%, p= 0.055, ß= -0.827), and the left ventricular ejection fraction less than 50% (0.202-0752, CI: 95%, p= 0.005, ß= -0.943). CONCLUSION: Considering the predictive factors, the duration of the postoperative endotracheal tube can play an important role in the careful care of elderly patients after CABG.