Analgesia with Coronary Arterial Bypass Graft Procedure - Dissertation Example

Health professionals such as physicians, nurses and aides agree that it is necessary to recommend the most appropriate treatment, which will contribute to pain relief in its entirety (Eileen 2006). The control and management of pain is a patient's right, by which organizations need to work to ensure compliance (Eileen 2006). The prevention of pain should be the goal of all health personnel because painful exposures have the potential for deleterious consequences (Gordon 2005). Relieve from pain is certainly an important issue but it is essential to establish a diagnosis before there is an increase in deterioration of the patient’s health as an early diagnosis will be helpful in commencing an appropriate treatment which will resuilt in an early relief of symptoms including pain (Eileen 2006; Waldman 2006).

CABG is a procedure performed in order to remove clots caused by coronary artery disease. The clot leads to a narrowing of the vessel wall thereby reducing the amount of blood passing through it, limiting the amount of oxygen and nutrients supplied and affecting the function of heart muscle (Ferraris 2008). The procedure involves by passing the blocked portion of affected vessel with another piece of blood vessel; known as ‘graft’. The graft is usually obtained from harvesting saphenous vein or an internal mammary artery (Beckeman 2012).

About 60% patients experience moderate to severe pain post operative pain following coronary artery bypass graft surgery (Weissman 1999). Significant pain control becomes challenge in such conditions as it may lead to certain complications like ischemia (Mangano 1992). Myocardial ischemia has been described as one of the major causes of abrupt cardiac death. About 80% of these patients suffer with coronary heart disease. Myocardial ischemia results in obstruction of the blood flow through cardiac vessels affecting the oxygen supply and exchange of other nutrients to the affected areas.

Vitiated cellular metabolism can ultimately result in development of deadly cardiac arrhythmias. (Ann 2012). Different analgesic drugs such as Propofol, Fentanyl, Morphine, Midazolam and Ketamine are now in practice for use in CABG surgery. After anesthetizing the patient and before opening the chest the patient is given a dose of morphine or fentanyl, then different anaesthesia drugs such as Propofol, Fentanyl, Midazolam and Ketamine alone or as mixture. As the patient is unconscious it can be difficult to determine the effectiveness of pain relief; however the level of analgesa and awareness can be measured with the use of a device known as Bispectral Index This device works by analyzing the patient’s electroencephalogram during general anesthesia (Myles 2009).

Also physiological signs such as the patient moving, sweating, hypertension and lacrimation can be used as indicators of pain (Desborough 2000). METHODOLOGY A literature review is an appropriate way to answer the research question and give a full holistic view of the problem (Aveyard 2007). This literature review allows further more comprehensive review of the literature giving a wider picture of the analgesia used during CABG