Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Clinical TrialEffects of thoracic epidural analgesia on coronary hemodynamics and myocardial metabolism in coronary artery bypass surgery.
A possible influence of thoracic epidural analgesia on coronary hemodynamics and myocardial metabolism in coronary artery bypass grafting was investigated. ⋯ With regard to the coronary circulation and myocardial metabolism, no hard data supporting the use of thoracic epidural analgesia in coronary artery bypass grafting were found.
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intrapleural versus intravenous morphine for postthoracotomy pain management.
To compare the analgesic effects of intrapleural and intravenous morphine administration for postthoracotomy pain management. ⋯ IPM achieved better analgesia than IVM and this effect is probably attributable to peripheral effects of morphine.
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Clinical TrialClosed mitral valvotomy and elective ventilation in the postoperative period: effect of mild hypercarbia on right ventricular function.
It is customary to extubate patients immediately after closed mitral valvotomy. These patients often have deranged respiratory function caused by chronic lung congestion. The left ventricular function may also be subnormal after valvotomy in some patients. Therefore, elective ventilation for some duration in the postoperative period can be beneficial to these patients. This work is an attempt to find whether elective ventilation should be preferred over immediate extubation in these patients. ⋯ Avoidance of even mild hypercarbia, therefore, appears advisable in the early postoperative period because of potential impedence to right ventricular ejection. Continuous monitoring of end-tidal CO2 and frequent blood gas analyses should be practiced, and elective ventilation should be considered in patients with long-standing disease and pulmonary hypertension.
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of amrinone with sodium nitroprusside for control of hemodynamics during infrarenal abdominal aortic surgery.
The control of hemodynamic changes during surgical resection of abdominal aortic aneurysms (AAA) remains a challenge to anesthesiologists. In the past, hypertensive episodes have been treated with sodium nitroprusside (SNP). However, amrinone may provide some benefits when compared with SNP because of its positive inotropic and vasodilatory properties. Therefore, the purpose of this study was to compare amrinone with SNP for hemodynamic control during AAA surgery. ⋯ This study demonstrates that amrinone provides equivalent hemodynamic control to SNP during abdominal aortic aneurysm surgery because it allows moderate reductions in blood pressure without affecting other hemodynamic measurements. Further studies are needed to assess whether patients with poor preoperative left ventricular function would benefit from amrinone management during AAA resection.