Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1992
Randomized Controlled Trial Clinical TrialIncidence of sore throat and patient complaints after intraoperative transesophageal echocardiography during cardiac surgery.
To evaluate the incidence of postoperative side effects and patient complaints following transesophageal echocardiography (TEE), 57 patients were interviewed by questionnaire and examined by pharyngeal inspection, preoperatively. The patients were randomized to undergo surgery with or without intraoperative TEE, and a second interview and examination were performed in 48 patients on the second postoperative day using a double-blind protocol. Twenty-four of the patients were investigated by TEE over a period of 5.4 +/- 2.3 hours and 24 had surgery without TEE. ⋯ No differences between the groups were found regarding the findings on pharyngeal inspection and no major complication attributable to the use of TEE occurred. A sore throat with painful swallowing was not a great problem for the patients in the present study; this indicates that endotracheal intubation rather than TEE caused the minor complaints. It is concluded that intraoperative TEE can be used without harmful postoperative pharyngeal side effects.
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J. Cardiothorac. Vasc. Anesth. · Feb 1992
Continuous noninvasive blood pressure monitoring during thoracic surgery.
To evaluate the usefulness of noninvasive blood pressure monitoring during thoracic surgery, blood pressure measurements obtained with the Finapres 2300 (Ohmeda, Boulder, CO) were compared with an intraarterial catheter system in 10 patients undergoing thoracotomy for lobectomy or pneumonectomy. The Finapres measurements were compared with pressure data obtained ipsilaterally from a radial artery catheter-transducer system. The waveforms were recorded using a strip chart recorder; the systolic (SBP) and diastolic blood pressures (DBP) were measured every 20 seconds on the paper trace. ⋯ The Finapres underestimated SBP during two-lung ventilation, and overestimated SBP during one-lung ventilation. The precision was good and the biases were small, but there were wide individual variations. It is concluded that the Finapres can be useful in estimating the variability and following the trends of radial arterial blood pressure during thoracic surgery, and is an acceptable alternative to invasive blood pressure monitoring.
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J. Cardiothorac. Vasc. Anesth. · Feb 1992
Case ReportsTransesophageal echocardiography and the intraoperative management of pediatric congenital heart disease: initial experience with a pediatric esophageal 2D color flow echocardiographic probe.
Intraoperative color Doppler transesophageal echocardiography (TEE) was performed in 26 patients undergoing corrective or palliative surgery for congenital heart disease. Age ranged from 1 day to 15 years, and body weight ranged from 2.9 to 42 kg. Objectives of the study were to determine the smallest infant in whom the pediatric probe could be used safely, additional diagnostic value, and it role in the intraoperative assessment of the surgical repair. ⋯ Assessment of the surgical repair was obtained in the immediate postcardiopulmonary bypass period. No short-term complications occurred in this series. Intraoperative color Doppler TEE provided a detailed and accurate assessment of the morphology, the function of the heart, and altered the management of at least two patients.