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Background: Sleep disorders after heart surgery lead to increased heart rate, myocardial oxygen demand, and cause dysrhythmia that worsens heart ischemia. The purpose of this study was to determine the effect of head and facial massage on sleep conditions following coronary artery bypass graft surgery. Materials and methods: A randomized controlled trial was performed on 72 patients. They were randomly divided into interventional (n = 36) and control groups (n = 36). On the third to fifth day after the operation, head and the facial massage were done for 15 min in the intervention group. The patients in the control group received only routine care. Richard Campbell's Sleep Questionnaire was completed for four consecutive days for each group. Data were analyzed in SPSS V26. Results: Mean scores for sleep conditions before the intervention no statistically significant difference seen between the two groups (P > 0.05). After the intervention, there was a statistically significant difference between mean scores for sleep conditions of the interventional and control groups (P < 0.001). Also with general estimated equation test compared mean scores for sleep conditions between two groups. That revealed sleep condition total score in the intervention group was more than the control group and the trend of changes over time was statistically significant (P < 0.001). Conclusion: Head and facial massage is an effective nursing intervention in improving the sleep condition of patients after coronary artery bypass graft. Due to the fact that head and face massage is an easy method and brings patient satisfaction, it is recommended to use this method as a suitable supplement for drug therapy and postoperative interventions in these patients. [ABSTRACT FROM AUTHOR]

Introduction: The administration of lidocaine to maintain cognitive function following coronary artery bypass grafting (CABG) and valve plasty is a controversial concept in terms of its effectiveness. We performed a systematic review to determine the effectiveness of treatment with lidocaine in preventing the occurrence of cognitive deficit after cardiac surgery. Area covered: To review the current literature on the subject, we searched the PubMed database and the Cochrane Library database (up to May 2015) and compiled a list of retrieved articles. Our final review includes only randomized controlled trials (RCTs) that compared lidocaine to a control (placebo) following CABG and valve plasty. Statistical analysis of the odds ratio (OR) and corresponding 95% confidence interval (CI) were used to determine the overall effectiveness of lidocaine for the prevention of cognitive deficit with both procedures. The Mantel–Haenszel method was used to pool data of the outcomes of cognitive deficit occurrence into fixed-effect model meta-analyses. Five RCTs were included in this study, with a total of 688 patients. Perioperative administration of lidocaine in patients undergoing cardiac surgery reduced occurrence of cognitive deficit (OR 0.583 [95% CI 0.438–0.777]; Z = -3.680; P = 0.00; I2= 52%). No significant difference in the early occurrence of cognitive deficit was revealed in patients after cardiac surgery (OR 0.909 [95% CI 0.600–1.376]; Z = -0.451; P = 0.652; I2= 11%). Expert commentary: Cognitive deficit associated with cardiac surgery is a common postoperative event. Lidocaine is contributed to a significantly reduced occurrence of cognitive deficit. Cognitive deficit management is recommended. [ABSTRACT FROM AUTHOR]

Background and purpose: Influence factors on the outcome of coronary artery disease have always been important for choosing the best treatment option. Ischemic mitral regurgitation (IMR) is one of these factors. Treating patients with coronary artery bypass grafting (CABG) and concomitant dysfunctional valve repair has always been a challenge since there are many risks involved. The purpose of this study was to investigate the changes of IMR after coronary artery bypass grafting, to make a rational decision about surgical repair of mitral valve insufficiency during CABG.. Materials and methods: A semi-experimental study was conducted in patients with coronary artery disease and IMR who underwent isolated CABG between 2011-2013. Echocardiography was performed for patients before and after CABG. Results: The study was performed in 80 patients who were divided into three groups. The patients were 36.6% in mild, 42.5% in mild to moderate and 21.3% were in moderate group. After surgery, 55% were in mild, 38.8% in mild to moderate and 6.3% were in moderate group. In this study, the greatest change was observed in mild to moderate group. Conclusion: According to the results of the intervention surgery (CABG) in patients with IMR both Mild To Moderate and Moderate improves levels of IMR and reduced the severity of MR, but in Mild group these changes were statistically significant (P<0.05). [ABSTRACT FROM AUTHOR]

Background and purpose: Coronary artery disease (CAD) is the first cause of death in modern societies. It is also the first cause for individual health care cost. Multiple risk factors are mentioned for its development among which elevated uric acid is recently introduced as an inflammatory factor. This study was performed for evaluating the serum uric acid level and severity of CAD determined by coronary angiography in patients with chronic stable angina after considering and adjusting other risk factors such as age, smoking (C.S), hypertension (HTN), hyperlipidemia (HLP) and diabetes mellitus (DM). Materials and methods: This cross-sectional analytic study was performed in 200 patients with chronic stable angina to determine the relationship between the level of serum uric acid and severity of coronary atherosclerosis in angiography. Other common cardiovascular risk factors including age, DM, HTN, HLP and C.S were also considered. Results: A total of 78 women (39%) and 123 men (61%) were included in the study. There were no significant differences between sex and risk factors including DM, HTN, HLP, C.S, age and serum uric acid level. In the studied population, the mean severity of coronary atherosclerosis score measured by Gensini score was 15.8± 10.7 and the mean level of uric acid was 10.5±6mg/dl. Significant correlation was seen in severity of coronary atherosclerosis and level of serum uric acid in the study population (r=0.51, 0.537, respectively P<0.0001). Also, there was significant correlation between coronary atherosclerosis severity and HTN, age, DM and HLP. Multivariate analysis showed 15% contribution of serum uric acid level in developing coronary atherosclerosis. Conclusion: This study showed an independent relationship between serum uric acid level and severity of coronary atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Considering the side effects of pharmacological methods, there has been a suggestion to use nonpharmacological methods such Aromatherapy following coronary artery bypass grafting (CABG). This study aims to evaluate the effectiveness of lavender 2% aromatherapy on sternotomy pain intensity after coronary artery bypass graft surgery in patients who have undergone surgery., Materials and Methods: During this clinical trial, 50 patients who were candidates for CABG, were randomly divided into two equal groups, that is, the control group (n = 25) and the case group (n = 25). Following CABG, the case group received two drops of 2% lavender oil every 15 minutes with supplemental oxygen and the control group received only supplemental oxygen through a face mask. The data collection tools comprised of the demographic check list and visual analog scale (VAS) for evaluating the pain intensity. The pain intensity were assessed pre- and five, 30, and 60 minutes post aromatherapy. The final data were analyzed by the t-test and chi-squared test., Results: The findings showed that the pain perception intensity in the case group was lower than that in the control group at the 30- and 60-minute phases after intervention (P < 0.0001)., Conclusion: The result indicated that aromatherapy can be used as a complementary method in postoperative pain reduction, as it reduced pain. The patients require two sedative drugs, and moreover, it avoids expenses of treatment.