Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Hemodynamic changes during displacement of the beating heart using epicardial stabilization for off-pump coronary artery bypass graft surgery.
To evaluate the hemodynamic alterations during off-pump coronary artery bypass graft surgery to determine the degree of impairment caused and the techniques to rectify them. ⋯ Most patients had hemodynamic changes easily correctable by fluids and inotropes. Monitoring of left ventricular and right ventricular function by transesophageal echocardiography enhances safety of the procedure and is recommended. The use of the Octopus II tissue stabilizer proved to be a safe and versatile means to stabilize the heart during off-pump coronary artery bypass procedures, especially in high-risk patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Randomized Controlled Trial Clinical TrialCentrifugal versus roller head pumps for cardiopulmonary bypass: effect on early neuropsychologic outcomes after coronary artery surgery.
To test the hypothesis that routine use of a centrifugal pump in the cardiopulmonary bypass circuit would result in a lower incidence of early neuropsychologic deficit when compared with conventional roller pumps. ⋯ There was no significant difference in the incidence of neuropsychologic deficit postoperatively with routine use of centrifugal pumps. The larger number of individual test deficits in the roller pump group suggest that further studies to assess the potential neuropsychologic benefits of the use of centrifugal pumps are warranted.
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Randomized Controlled Trial Clinical TrialA combination of intrathecal morphine and remifentanil anesthesia for fast-track cardiac anesthesia and surgery.
To determine if the combined remifentanil and intrathecal morphine (RITM) anesthetic technique facilitates early extubation in patients undergoing coronary artery bypass graft (CABG) surgery. ⋯ Implementation of the RITM technique provided earlier tracheal extubation, decreased level of sedation, excellent analgesia, and improved spirometry in the early postoperative period. The impact of RITM on ICU and hospital length of stay and potential cost benefits require further evaluation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Randomized Controlled Trial Clinical TrialRemifentanil-clonidine-propofol versus sufentanil-propofol anesthesia for coronary artery bypass surgery.
To compare a remifentanil-clonidine-propofol regimen with conventional sufentanil-propofol anesthesia. ⋯ Compared with a sufentanil-propofol regimen, an anesthetic regimen for CABG surgery that combines remifentanil, clonidine, and propofol provides similar hemodynamics. The remifentanil-clonidine regimen reduces catecholamine levels and hastens recovery from anesthesia.
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Thoracic epidurals in heart valve surgery: neurologic risk evaluation.
To evaluate the risk of neurologic complications resulting from epidural hematoma in a series of patients who had surgery for repair or replacement of heart valves under combined general and thoracic epidural anesthesia (TEA). ⋯ TEA can provide effective postoperative analgesia and assist in early tracheal extubation in cardiac valve surgery. In this series, there were no neurologic deficits detected. When certain safety measures are taken, routine TEA is feasible and helpful in cardiac valve surgery.