Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2005
Randomized Controlled Trial Comparative Study Clinical TrialFast-track coronary artery bypass grafting surgery under general anesthesia with remifentanil and spinal analgesia with morphine and clonidine.
Effective postoperative analgesia is a critical part of fast-track cardiac surgery. This study compared the postoperative analgesic effect of fast-track anesthesia with remifentanil and spinal morphine and clonidine with that of sufentanil anesthesia followed by patient-controlled administration of intravenous morphine. ⋯ The combination of anesthesia with remifentanil and spinal analgesia with morphine and clonidine produces effective analgesia after coronary artery surgery and a rapid extubation time.
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J. Cardiothorac. Vasc. Anesth. · Feb 2005
Randomized Controlled Trial Comparative Study Clinical TrialEffects of positive end-expiratory pressure on ventilatory and oxygenation parameters during pressure-controlled one-lung ventilation.
The purpose of this study was to investigate the effects of PEEP on oxygenation and airway pressures during PCV-OLV. ⋯ During OLV, PCV with a low level of PEEP leads to improved oxygenation with lower airway pressures.
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J. Cardiothorac. Vasc. Anesth. · Feb 2005
Randomized Controlled Trial Comparative Study Clinical TrialRemifentanil use in children undergoing congenital heart surgery for left-to-right shunt lesions.
The authors compared the effects of remifentanil with fentanyl on the hemodynamic and respiratory variables in children with left-to-right shunting and pulmonary hypertension. ⋯ There were no clinically important differences in hemodynamic and respiratory measurements intraoperatively and during the initial 24 hours postoperatively between fentanyl and remifentanil in pediatric patients undergoing surgical repair of defects with left-to-right shunts.
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J. Cardiothorac. Vasc. Anesth. · Feb 2005
Comparative Study Clinical TrialComparison of three anesthetic techniques for off-pump coronary artery bypass grafting: general anesthesia, combined general and high thoracic epidural anesthesia, or high thoracic epidural anesthesia alone.
This study compared general anesthesia (GA), combined GA plus thoracic epidural anesthesia (TEA), and TEA alone in patients scheduled for off-pump coronary artery bypass grafting. ⋯ Based on the authors data, all anesthetic techniques were equally safe from the clinicians standpoint. However, GA+TEA appeared to be most comprehensive, allowing for revascularization of any coronary artery, providing good hemodynamic stability and reliable postoperative pain relief. Nonetheless, the actual and potential risks of TEA during cardiac surgery should not be underestimated.
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J. Cardiothorac. Vasc. Anesth. · Feb 2005
Comparative StudyHypercoagulability affecting early vein graft patency does not exist after off-pump coronary artery bypass.
Hypercoagulability may compromise the patency of bypass grafts. The authors hypothesized that perioperative in vitro platelet responses to varying agonists (eg, thrombin, platelet activating factor, collagen, adenosine diphosphate) correlate with early graft thrombosis after off-pump coronary artery bypass grafting (OPCAB). ⋯ OPCAB is not associated with a significant activation in postoperative platelet function. This study suggests that if hypercoagulability exists after OPCAB, it is not involved in the pathogenesis of arterial thrombotic events such as early bypass graft failure.