Early administration of medications
It is well established that early administration of some medications,
such as aspirin, in the postoperative period may play an important role
in improving outcomes after cardiac surgery. According to the 2011
ACCF/AHA guidelines for CABG, if aspirin was not initiated
preoperatively, this should be done within 6 hours postoperatively and
continued permanently to prevent saphenous vein graft (SVG) closure and
adverse cardiovascular events [27]. Similarly, the 2008 European
association for cardio-thoracic surgery (EACTS) guidelines recommend
that all patients without contraindications should be given aspirin
postoperatively within 24 hours of a CABG [28]. Early aspirin
administration was associated with better graft patency and overall
survival and significant reductions in stroke, myocardial infarction,
renal failure and bowel infarction incidence [29,30,31].
NGT has proved to be an effective method for delivering mediations
post-operatively. Zafar et al. (2009) compared the administration of
tablets orally or via NGT and found that NGT was associated with earlier
peak concentrations and an overall greater absorption and
bioavailability [4]. Shennib et al. (2003) investigated the
feasibility of delivering combined clopidogrel and aspirin regimen early
after CABG orally or via NGTs. Both routes were found to be safe and
were associated with better graft patency [5].