BACKGROUND: We aimed to investigate the preoperative, operative, and postoperative factors affecting intra-aortic balloon pump (IABP) insertion in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). We also investigated factors affecting morbidity, mortality, and survival in patients with IABP support. METHODS: Between January 2002 and December 2009, 1,657 patients underwent isolated CABG in Izmir Katip Celebi University Ataturk Training and Research Hospital. The number of patients requiring support with IABP was 134 (8.1%). RESULTS: In a multivariate logistic regression analysis, prolonged cardiopulmonary bypass time and prolonged operation time were independent predictive factors of IABP insertion. The postoperative mortality rate was 35.8% and 1% in patients with and without IABP support, respectively (p=0.000). Postoperative renal insufficiency, prolonged ventilatory support, and postoperative atrial fibrillation were independent predictive factors of postoperative mortality in patients with IABP support. The mean follow-up time was 38.55+/-22.70 months and 48.78+/-25.20 months in patients with and without IABP support, respectively. The follow-up mortality rate was 3% (n=4) and 5.3% (n=78) in patients with and without IABP support, respectively. CONCLUSION: The patients with IABP support had a higher postoperative mortality rate and a longer length of intensive care unit and hospital stay. The mid-term survival was good for patients surviving the early postoperative period.
Atrial Fibrillation ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Follow-Up Studies ; Humans ; Intensive Care Units ; Intra-Aortic Balloon Pumping ; Length of Stay ; Logistic Models ; Mortality ; Postoperative Period ; Renal Insufficiency ; Risk Factors

Background: Adductor canal block (ACB) provides effective analgesia after arthroscopic knee surgery. However, there is insufficient data regarding whether ACB should be performed before or after inflation of a thigh tourniquet. We aimed to investigate the efficacy of ACB performed before and after placement of a thigh tourniquet and evaluate associated quadriceps motor weakness. Methods: ACB was performed before tourniquet inflation in the PreT group, and it was performed after inflation in the PostT group. In the PO group, ACB was performed at the end of surgery after deflation of the tourniquet. Results: There were no statistically significant differences between the groups in terms of demographic data. There was no statistically significant difference among the three groups in terms of total postoperative opioid consumption (P = 0.513). Patient satisfaction and the amount of rescue analgesia administered were also not significantly different between the groups. There was no significant difference in terms of static and dynamic visual analog scale scores between the groups (for 24 h: P = 0.306 and P = 0.271, respectively). The incidence of motor block was higher in the PreT group (eight patients) than in the PostT group (no patients) and the PO group (one patient) (P = 0.005). Conclusions Using a tourniquet before or after ACB did not result in differences in terms of analgesia quality; however, applying a tourniquet immediately after ACB may lead to quadriceps weakness.