Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1994
Another application of two-dimensional transesophageal echocardiography: spinal cord imaging. A preliminary report.
This prospective study was performed in 17 consecutive patients continuously monitored intraoperatively and postoperatively for cardiac function with two-dimensional (2D) TEE. Prior to systematic evaluation of spinal cord imaging by 2D TEE, the aims of this study were to determine: (1) the feasibility of such imaging, and (2) the relationship between spinal cord images and fixed structures (like vertebral bodies); 7.5 +/- 2.3 spinal segments were identified in the patients. ⋯ Successful imaging of the spinal cord was achieved in all 17 patients with visualization of discs, spinous processes, spinal canal, and a pulsating spinal cord. Further studies are needed to better define the potential applications of this new technique: detection of spinal cord trauma, visualization of a thoracic epidural catheter, and successful preservation of spinal cord vascularization during thoracic aortic surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 1994
A computer-controlled, closed-loop infusion system for infusing muscle relaxants: its use during motor-evoked potential monitoring.
A microcomputer-controlled closed-loop infusion system (MCCLIS) has been developed that provides stable intraoperative levels of partial neuromuscular blockade. Complete neuromuscular blockade interferes with intraoperative motor-evoked potential (MEP) monitoring used for patients undergoing surgical procedures that place them at risk for spinal cord ischemia. ⋯ Intraoperative adjustment of partial neuromuscular blockade to facilitate TcM-MEP monitoring was also possible with the MCCLIS. The MCCLIS should allow for further investigation into the sensitivity, specificity, and predictability of TcM-MEP monitoring for any patient at risk for intraoperative spinal cord ischemia including those undergoing thoracoabdominal aortic aneurysmectomy.
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J. Cardiothorac. Vasc. Anesth. · Dec 1993
Diltiazem and regional left ventricular function during graded coronary constriction and propofol anesthesia in the dog.
Although calcium channel blockers may preserve function in ischemic myocardium, they may also produce myocardial depression and dysfunction in the presence of decreased coronary flow. This study was designed to examine the issue of possible protection afforded by diltiazem against ischemia-induced myocardial dysfunction during propofol anesthesia. In eight anesthetized and ventilated dogs, regional myocardial (ultrasonic crystals in both left anterior descending [LAD] and left circumflex [LC] perfusion areas) and global ventricular function were evaluated during progressively severe degrees of myocardial ischemia (LAD constriction) before and after intravenous diltiazem (150 micrograms/kg). ⋯ The regional muscle effects of the reductions in coronary flow in the LAD perfusion territory included decreased systolic shortening and increased postsystolic shortening before and after diltiazem. Diltiazem did not alter the magnitude of the alterations in systolic or postsystolic shortening brought about by coronary constriction. No changes occurred in the LC area.(ABSTRACT TRUNCATED AT 250 WORDS)