ABSTRACT
The COVID-19 pandemic had significant impact on health care worldwide which has led to a reduction in all elective admissions and management of patients through virtual care. The purpose of this study is to assess changes in STEMI volumes, door to reperfusion, and the time from the onset of symptoms until reperfusion therapy, and in-hospital events between the pre-COVID-19 (PC) and after COVID-19 (AC) period. All acute ST-segment elevation myocardial infarction (STEMI) cases were retrospectively identified from 16 centers in the Kingdom of Saudi Arabia during the COVID-19 period from January 01 to April 30, 2020. These cases were compared to a pre-COVID period from January 01 to April 30, 2018 and 2019. One thousand seven hundred and eighty-five patients with a mean age 56.3 (SD ± 12.4) years, 88.3% were male. During COVID-19 Pandemic the total STEMI volumes was reduced (28%, nâ¯=â¯500), STEMI volumes for those treated with reperfusion therapy was reduced too (27.6%, n= 450). Door to balloon time < 90 minutes was achieved in (73.1%, noâ¯=â¯307) during 2020. Timing from the onset of symptoms to the balloon of more than 12 hours was higher during 2020 comparing to pre-COVID 19 years (17.2% vs <3%, respectively). There were no differences between the AC and PC period with respect to in-hospital events and the length of hospital stay. There was a reduction in the STEMI volumes during 2020. Our data reflected the standard of care for STEMI patients continued during the COVID-19 pandemic while demonstrating patients delayed presenting to the hospital.
Subject(s)
COVID-19 , Patient Acceptance of Health Care , Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Time-to-Treatment/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Disease Transmission, Infectious/prevention & control , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Outcome and Process Assessment, Health Care , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Percutaneous Coronary Intervention/methods , Percutaneous Coronary Intervention/statistics & numerical data , Retrospective Studies , SARS-CoV-2 , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/epidemiology , ST Elevation Myocardial Infarction/therapy , Saudi Arabia/epidemiology , Severity of Illness Index , Standard of Care/organization & administrationABSTRACT
BACKGROUND: Post-thoracotomy pain syndrome (PTPS) can be challenging to treat. AIM: This study aimed to evaluate the efficacy of perioperative pregabalin in the prevention of acute and chronic post-thoracotomy pain. METHODS: Sixty patients scheduled for thoracotomy for oncologic surgeries were randomly allocated to one of two groups; Pregabalin and Control. In the Pregabalin group, pregabalin 150 mg was administered one hour before thoracotomy and 12 hours later, then every 12 hours for five days. Pain intensity was assessed using the Visual Analogue Scale (VAS) at rest (VAS-R) and dynamic (VAS-D) in the ICU and during the next four days. Morphine consumption and the frequency of side effects were recorded. Assessment of PTPS was done using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale at 1, 2, and 3 months. RESULTS: The VAS-R and VAS-D scores and the total morphine consumption were significantly lower in Pregabalin group during days 0 through 4. Neuropathic pain, allodynia, and hyperalgesia were significantly lower in Pregabalin group after 1, 2, and 3 months. CONCLUSION: Pregabalin is effective in the reduction of chronic neuropathic pain at 1, 2, and 3 months after thoracotomy and it also reduces pain and opioid consumption during the acute postoperative period with few adverse effects.
