Abstract 14982: Paravertebral Block With a Paravertebral Catheter May Improve Outcomes After Minimally-invasive Cardiac Surgery
Bibliographic record
Abstract
Background: Postoperative (post-op) pain following minimally-invasive cardiac surgery (MICS) may complicate outcomes in patients having surgery performed through a right mini-thoracotomy. Regional anaesthesia, by delivery of local anaesthetic agents to the paravertebral space using a paravertebral catheter (paravertebral block, PVB) may be useful to reduce post-op pain, however, few studies have reported outcomes on patients undergoing MICS with the use of a PVB. Methods: Ninety consecutive patients who underwent MICS at Vancouver General Hospital between January 2016 and May 2019 were included in this retrospective study. Data were collected for 53 patients who only had routine pain control (control) and 37 patients who had a PVB (PVB). Primary outcomes were post-op opioid use and hospital length of stay (LOS). Peri-operative (peri-op) death and stroke were secondary outcomes. Statistical analyses were performed using ANOVA single factor and t-tests. Results: Patient demographics and operative times were comparable between the two groups. The average total amount of opioid consumed in the PVB group was lower at 155.3 mg morphine equivalents, compared to 193.9 mg in the control group, however, the difference was not statistically significant (p=0.39) (Figure 1). However, the percentage of patients who did NOT receive any oxycodone was almost double in the PVB group (43.2% vs 24.5%, PVB vs control, respectively. p=0.06). The average LOS for the PVB group was significantly lower than the control group (5.4 vs 8.3 days, PVB vs control, respectively. p=0.006) (Figure 1). There were no peri-op deaths or strokes. Conclusion: In our experience, addition of a regional anesthetic was associated with ~20% reduction in the amount of opioid narcotic required. Although not statistically significant, this may be a clinically important difference, as the LOS was significantly lower in the PVB group. Outcomes in patients undergoing MICS may be improved with the addition of a PVB.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".