Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Aug 1996
Hyperglycemia during hypothermic cardiopulmonary bypass does not alter postbypass vascular endothelial responses in dogs.
Hyperglycemia during hypothermic cardiopulmonary bypass (CPB) may alter intrinsic vasomotion by reducing endothelial-dependent vasorelaxation. Using a canine model of hypothermic CPB, this study tested whether hyperglycemia altered the vasodilator response to acetylcholine (ACh) and the vasoconstrictor response to phenylephrine (Phe). ⋯ The reduction in ACh-mediated vasorelaxation after CPB did not differ between hyperglycemic and normoglycemic animals, indicating that hyperglycemia does not contribute to impaired vasorelaxation after CPB. Because Phe-induced vasoconstriction was unaffected, hyperglycemia during hypothermic CPB does not appear to increase the potential for postbypass vasospasm.
-
J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparative effects of plain and epinephrine-containing bupivacaine on the hemodynamic response to cervical plexus anesthesia in patients undergoing carotid endarterectomy.
This study was designed to investigate whether the addition of epinephrine as a vasoconstrictor additive to local anesthetic affects the hemodynamic profile after cervical plexus block in patients presenting for carotid endarterectomy. ⋯ Concerning cervical plexus block with bupivacaine, the use of epinephrine is associated with an increase in heart rate consistent with a beta-adrenergic effect from systemic absorption of the epinephrine. An increase in systolic blood pressure independent of the use of epinephrine also occurs, but epinephrine appears to mitigate against an increase in diastolic blood pressure.
-
J. Cardiothorac. Vasc. Anesth. · Aug 1996
Comparative StudyA comparison of the endobronchial segment of modern left-sided double-lumen tubes in anesthesia for bilateral sequential lung transplantation.
To compare a range of currently available left-sided double-lumen endotracheal tubes (DLTs) in order to demonstrate differences among them with respect to the length of the endobronchial segment. It is proposed that a tube with a short endobronchial segment is better suited to anesthesia under the conditions imposed by double sequential lung transplantation. ⋯ There exists marked variability in the length of the endobronchial segment of left-sided double-lumen tubes currently available. These differences may be significant in anesthesia for bilateral sequential lung transplantation.
-
J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Clinical TrialChanges in heart rate variability during induction of anesthesia with fentanyl and midazolam.
The study was designed to evaluate changes in autonomic nervous system function during induction of anesthesia with fentanyl, midazolam, and pancuronium and to answer the question of dose-dependency of these effects. ⋯ Parameters of HRV suggest that induction with fentanyl, midazolam, and pancuronium decreases sympathetic but not parasympathetic autonomic system activity. The anesthetic induction technique's modulation of autonomic nervous system balance is better represented by means of spectral analysis than by analysis in the time domain. This modulation was largely independent of the doses administered and independent of the speed of injection.
-
J. Cardiothorac. Vasc. Anesth. · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialPerioperative course and recovery after heparin-coated cardiopulmonary bypass: low-dose versus high-dose heparin management.
To compare two heparin managements for a cardiopulmonary bypass (CPB) procedure with heparin-coated equipment. The hypothesis was that a lower heparin dose may reduce blood loss and homologous transfusion requirements and influence the speed of postoperative recovery. ⋯ Low-dose heparin management enabled uneventful procedures with heparin-coated CPB equipment, significantly decreased protamine and homologous blood requirements, but did not reduce chest drainage or influence the postoperative course and recovery in patients after coronary artery surgery.