Pain-diminishing effects of Kinesio® taping after median sternotomy

Background: Postoperative pain and severe side effects of opioid analgesics present a clinical challenge after cardio-thoracic surgery. In this study, the impact of Kinesio® taping on postoperative morbidity after median sternotomy was observed. Methods: Thirty-nine patients (mean age 66 ± 9 years, CI: 63.28; 68.98) who underwent median sternotomy between 09/2014 and 11/2014 participated in this prospective randomized controlled trial. Patients were assigned into a treatment on a non-treatment group. Patients in the treatment group were taped after leaving the intensive care unit. We assessed, pain, consumption of pain medication, the subjective estimation of patients’ ability to breathe, radiologic and microbial abnormalities as well as adverse effects resulting from the tape use daily until discharge. To determine the patients’ satisfaction a discharge questionnaire was offered after completion of data. Results: Patients who were treated with tape report significantly less pain (2.14 ± 0.5, CI: 1.1; 3.13) than patients from the control group (4.16 ± 0.6, CI: 2.92; 5.41, p = 0.01). The need for opioid pain medication, as assessed by total analgesic consumption per patient, was significantly less in the treatment group (1.2 ml ± 0.4 ml, CI: 0.40 ml; 2.01 ml) versus (3.1 ml ± 0.5 ml, CI: 2.0 ml; 4.2 ml, p = 0.01). The subjective estimation of patients’ ability to breathe was significantly better (p < 0.001) and the satisfaction was higher in the Kinesio® tape group compared to the control group. Taped patients had a mean hospitalization of 10 ± 1 day (CI: 8.74 days; 11.78 days) untapped patients stayed for 11 ± 1 days (CI: 9.17 days; 11.83 days). Adverse effects from the tape treatment were not observed. Conclusions: Kinesio® taping after median sternotomy is a low-risk, non-pharmacologic, cost effective, and promising method for improving patients’ breathing conditions, reducing postoperative pain, pain medication consumption, and thus, potential adverse effects of analgesics.     

Differential effects of potassium channel blockers on the activity of the locomotor network in neonatal rat

The role played by various K+ channels during locomotor activity was studied using an in vitro neonatal rat spinal cord preparation. Locomotor-like activity was elicited by bath-applying serotonin (5-HT) and N-methyl-d-l-aspartate (NMA). Four different K+ channel blockers were tested by adding them to the superfusing saline. Each of the K+ channel blockers elicited a characteristic motor pattern with specific temporal parameters. Cs+ and tetraethyl ammonium both decreased the motor period, but had opposite effects on the burst amplitude. Apamin increased both the motor period and the burst amplitude. A dose-response relationship was established for the K+ channel blockers. The blockers elicited an unstable rhythmic activity, contrary to what occurred under control conditions. We also found that due to the specific changes that they elicit, the various blockers produce selective changes in the burst ratio. These results suggest that the various K+ channels contribute differently to the generation of locomotor activity.     

Noninvasive estimation of impaired hemodynamics for patients with acute myocardial infarction by Tei index.

BACKGROUND: Tei index, defined as the sum of isovolumic contraction and relaxation times divided by ejection time, has been proposed to express global left ventricular function. For patients with acute myocardial infarction (AMI), left ventricular function can potentially be a major determinant of hemodynamics with limited time for compensation, such as increased brain natriuretic peptide to attenuate congestion, and usually without any intervention to modify cardiac loading on arrival at the hospital during the acute phase. We, therefore, hypothesized that left ventricular function, expressed by the Tei index, allows noninvasive estimation of impaired hemodynamics for patients with AMI. METHODS: We studied 86 consecutive patients with first AMI (34 inferoposterior and 52 anteroseptal). Tei index was obtained as: (a - b)/b, where a is the interval between the cessation and onset of mitral flow and b is the ejection time by aortic flow by pulsed Doppler echocardiography. By using pulmonary capillary wedge pressure (PCWP) > or = 18 mm Hg or <18 mm Hg and cardiac index (CI) < or = 2.2 L/min/m(2) or > 2.2 L/min/m(2) by consecutive catheterization, patients were classified into 4 subsets: subset I with normal hemodynamics; subset II with elevated PCWP; subset III with reduced CI; and subset IV with both elevated PCWP and reduced CI. RESULTS: For patients with inferoposterior AMI, there was no significant correlation between the Tei index and PCWP or CI. For patients with anteroseptal AMI, however, the Tei index showed significant correlation both with PCWP (r = 0.59, P <.0001) and CI (r = -0.42, P <.01). Diagnosis of impaired hemodynamics (subset II-IV) by a Tei index > or = 0.60 showed a sensitivity, specificity, and accuracy of 86%, 82%, and 83%, respectively. CONCLUSIONS: Although the Tei index has limitations to evaluate hemodynamics in patients with inferoposterior AMI, the index allows approximate but quick and practical noninvasive estimation of impaired hemodynamics in patients with anteroseptal AMI.