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].