Background. Sternotomy causes considerable postoperative pain and postoperative pain management encompasses different analgesic regimens. In this study, we aimed to investigate the effect of peroperative parasternal block with levobupivacaine on acute and chronic pain after coronary artery bypass graft surgery. Materials and Methods. A total of 81 patients undergoing coronary artery bypass graft surgery were included in this study. Patients were randomly allocated by opening an envelope to receive either parasternal block with pharmacologic analgesia (group P; before sternal wire placement: sternotomy and mediastinal tube sites were infiltrated with local anesthetics) or pharmacologic analgesia alone (group C) for postoperative pain relief. All patients received intravenous tramadol with patient-controlled analgesia at the end of the surgery. Demographic characteristics, vital signs, tramadol consumption, analgesic intake, and intensity of pain with a visual analogue scale were recorded for each patient. Six months after surgery, the patients’ type of chronic pain was evaluated using the Leeds Assessment Neuropathic Symptoms and Signs pain scale questionnaire. Results. Patients who received parasternal block experienced less pain and needed less opioid analgesic (125.75 ± 28.9 mg in group P vs 213.17 ± 61.25 mg in group C) for 24 hours postoperatively (P < .001). There was no significant difference in nociceptive and neuropathic pain between the groups. Conclusion. Parasternal block had a benefical effect on the management of postoperative acute pain and decreased opioid consumption after surgery but had no significant effect in chronic post surgical pain.

Background. Parasternal block and transcutaneous electrical nerve stimulation (TENS) have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery.Objectives. To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery.Methods. One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group.Results. Pain scores recorded 4 h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Total morphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay.Conclusions. Parasternal block was more effective than TENS in the management of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy. This trial is registered with Clinicaltrials.gov numberNCT02725229.

Background: Nurses face a high level of mental workload while performing their duties. High levels of mental workload can negatively impact nurses. Aim: The aim of this research was to determine the relationship between mental workload and burnout levels of intensive care nurses. Study design: Descriptive‐correlational design has been adopted in this research. The sample consisted of 156 nurses working in the intensive care units of a hospital in the south of Turkey between September and December 2023. Research data were collected with the ‘Participant Information Form’, which includes socio‐demographic characteristics, ‘Mental Workload Scale’ and ‘Maslach Burnout Scale’. Results: Almost all (95.5%) of the nurses participating in the study reported that their mental workload was high. It has been determined that there is a strong positive relationship between mental workload and burnout. According to the regression model obtained from the research, being a woman ( β = .165, p = .008) and emotional workload ( β = −695, p < .001) are determinants of emotional exhaustion. These variables explain emotional exhaustion at a rate of 50.1% (adjusted R ² = .501). Emotional workload ( β = .399, p = .003) is the most important determinant of personal accomplishment. This variable explains 19.0% (adjusted R ² = .190) of personal accomplishment. The most important determinant of depersonalization is emotional workload ( β = .324, p < .001). It was determined that this variable explained 24.4% (adjusted R ² = .244) of depersonalization. Conclusions: This research revealed that there is a strong positive relationship between mental workload and burnout and that increasing mental workload can increase burnout. Relevance to Clinical Practice: Nurses' risk of emotional exhaustion increases as mental workload increases. Reducing cognitive workload, temporary workload and emotional workload increases the personal accomplishment experienced by nurses. In addition, as temporary workload, emotional workload and performance‐related workload increase, the depersonalization experienced by nurses also increases.