Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1999
The influence of nitrous oxide to supplement fentanyl/low-dose propofol anesthesia on transcranial myogenic motor-evoked potentials during thoracic aortic surgery.
Intraoperative monitoring of myogenic motor evoked potentials to transcranial electrical stimulation (tc MEPs) is a new method to assess the integrity of the motor pathways. The authors studied the effects of 50% nitrous oxide (N2O) and a low-dose propofol infusion on tc MEPs paired electrical stimulation during fentanyl anesthesia with partial neuromuscular blockade. ⋯ The data indicate that tc MEP monitoring is feasible during low-dose propofol, fentanyl/50% N2O in 02 anesthesia and partial neuromuscular blockade.
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J. Cardiothorac. Vasc. Anesth. · Feb 1999
Total intravenous anesthesia with remifentanil and propofol for implantation of cardioverter-defibrillators in patients with severely reduced left ventricular function.
To determine the cardiocirculatory effects of total intravenous anesthesia (TIVA) using remifentanil and propofol in high-risk cardiac surgical patients. ⋯ TIVA using remifentanil and propofol in patients with severely reduced left ventricular function is safe, well-controllable, and allows early extubation after implantation of an ICD. Because patients without complications did not need a postoperative intensive care stay, costs may be considerably reduced.
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One-lung ventilation is used to facilitate thoracic and cardiac surgery. This article describes the development and clinical use of a new device, the bronchial blocker tube, to establish one-lung ventilation. ⋯ In this setting, the bronchial blocker is a separate device which is replaceable, rotatable, and removable. In the authors' experience, the bronchial blocker tube was effective and easy to use.
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J. Cardiothorac. Vasc. Anesth. · Dec 1998
Randomized Controlled Trial Comparative Study Clinical TrialDopexamine unloads the impaired right ventricle better than iloprost, a prostacyclin analog, after coronary artery surgery.
To evaluate the ventricle-unloading properties of dopexamine and iloprost and to compare their effects on right ventricular (RV) function and oxygen transport in patients with low RV ejection fraction (RVEF) after cardiac surgery. ⋯ The findings suggest that dopexamine is more effective than iloprost for support and unloading of the postoperatively disturbed RV in terms of RVEF and end-systolic volume. The reduction of pulmonary vascular resistance after administration of iloprost without a decrease in end-systolic volume might not be considered a reduction of RV afterload. Iloprost increases the pulmonary shunt fraction, however, more than dopexamine, indicating a more prominent vasodilator effect.