Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Cardiac troponin I in diagnosis of perioperative myocardial infarction after cardiac surgery.
The diagnosis of perioperative myocardial infarction (PMI) after cardiac surgery remains an important issue. The present study was designed to determine the relevance of the measurement of serum cardiac troponin I (cTnI, a biochemical marker with high cardiospecificity. Therefore, cTnI was compared with creatine kinase-MB (CK-MB) mass and to the other classical signs of myocardial infarction after cardiac surgery. ⋯ A cTnI concentration less than 15 micrograms/L (mean + 2 standard deviations [SDs] of peak cTnI in group 3) within 24 to 48 hours after cardiac surgery is highly suggestive of the absence of perioperative myocardial necrosis. Because of its higher cardiospecificity than CK-MB mass, and its prolonged release after myocardial necrosis, cTnI might be a useful tool in the diagnosis of PMI after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialA comparative evaluation of intrapleural and thoracic epidural analgesia for postoperative pain relief after minimally invasive direct coronary artery bypass surgery.
To compare the efficacy of thoracic epidural analgesia (TEA) and intrapleural analgesia (IPA) after minimally invasive direct coronary artery bypass (MIDCAB) surgery with regard to quality of analgesia and complications. ⋯ IPA is a safe and effective technique for postoperative analgesia after MIDCAB surgery and has a low complication rate compared with TEA. Careful positioning, chest tube clamping, and anchoring of the catheter are mandatory for IPA to be effective.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialPleural bupivacaine placement for optimal postthoracotomy pulmonary function: a prospective, randomized study.
To determine dependent chest tube losses of bupivacaine with paravertebral versus interpleural administration, thereby helping to explain the significant differences in pulmonary function that exist between these two techniques. ⋯ Local anesthetic on the diaphragm might actively impair respiratory function through diaphragmatic and abdominal muscle weakness, while failing to contribute to pain relief.