Journal of cardiothoracic and vascular anesthesia
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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
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.
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Validation of continuous thermodilution cardiac output in patients implanted with a left ventricular assist device.
To assess the accuracy of a continuous cardiac output (CCO) monitor against an independent, intravascular measurement of flow as can be performed in patients fitted with a left ventricular assist device (LVAD). ⋯ The data indicate that the CCO system tends to overestimate cardiac output by approximately 500 mL/min when compared with LVAD flow. Nevertheless, this bias is within the range found by other less-invasive studies done to assess the accuracy of this system and further serves to confirm its relative accuracy.
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J. Cardiothorac. Vasc. Anesth. · Dec 2002
Time course of neuromuscular blockade with rocuronium in children with intracardiac shunts.
To evaluate the time course of neuromuscular blockade after rocuronium in children with intracardiac shunts. ⋯ This study shows a more rapid onset of rocuronium in children with cyanotic congenital heart disease. In these patients, rocuronium is indicated, particularly for rapid airway control.