Acta anaesthesiologica Scandinavica
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Amrinone has been shown to have a beneficial effect on left ventricular function in low output syndrome (LOS), but its use after open-heart surgery has not been extensively revised. We studied 10 patients with LOS post-cardiopulmonary bypass (CPB), who failed to respond to conventional treatment (vasoactive drugs plus intraaortic balloon pump) and were treated with amrinone, 0.75 mg.kg-1 followed by a continuous infusion of 5 to 10 micrograms.kg-1-min-1. One patient failed to respond to the treatment and subsequently died, but in the other nine patients blood pressure and cardiac index increased, left filling pressure decreased and they were successfully weaned from the CBP and survived. These results suggest that amrinone, either alone or combined with other inotropic drugs and mechanical support, is a valuable drug in the management of LOS after CPB.
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Acta Anaesthesiol Scand · Aug 1990
Randomized Controlled Trial Clinical TrialThe effect of removal of cerebrospinal fluid on cephalad spread of spinal analgesia with 0.5% plain bupivacaine.
Increased intraabdominal pressure is well known to cause higher cephalad spread of spinal analgesia. The reason for this is believed to be a decrease in the cerebrospinal fluid (CSF) volume. If this mechanism is correct, then the cephalad spread of local anesthetic solutions should also be facilitated when the CSF volume is intentionally reduced without increasing the intraabdominal pressure. ⋯ Mean cephalad spread of analgesia 20 min after injection in the three groups was T10.2 +/- 2.0, T9.4 +/- 1.8 and T7.0 +/- 2.1, respectively. When CSF was reduced by 5 ml, the level of spread not only showed a statistically significant difference from that of the control group, but also from that of Group II (P less than 0.05). Our results show that higher cephalad spread of spinal anesthetic is possible by reducing the CSF volume without evidence of increased intraabdominal pressure.