Journal of cardiothoracic anesthesia
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J Cardiothorac Anesth · Oct 1989
Anesthetic management of abdominal aortic surgery: a retrospective review of perioperative complications.
The incidence of perioperative complications was retrospectively reviewed in 103 patients who underwent replacement of the abdominal aorta from 1981 to 1987. Eighty-nine of the patients had associated systemic diseases, with hypertension being the most frequent (63%). Ischemic heart disease and cerebrovascular disease had an incidence of 12% and 13%, respectively. ⋯ Deterioration in renal function occurred in 6 patients, but with no difference between groups. There were three perioperative deaths (2.9%), with two of them resulting from cerebrovascular accidents in patients with a history of cerebrovascular disease. The overall morbidity and mortality were independent of the anesthetic technique.
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J Cardiothorac Anesth · Oct 1989
The mechanism of nitrous oxide-induced changes in pulmonary vascular resistance in a dog model of left atrial outflow obstruction.
Nitrous oxide has been reported to increase pulmonary vascular resistance (PVR) in patients with pulmonary hypertension secondary to mitral stenosis. Additional data suggest this response involves sympathetic stimulation because the increase in PVR can be prevented by alpha-adrenergic and ganglionic blockade. Whether or not active pulmonary vasoconstriction occurs remains unclear. ⋯ The inspired gas was then changed to 67% N2O and 33% O2 for 10 minutes, and then returned to the N2/O2 mixture. Once baselines had been reestablished (about 10 minutes), phentolamine, 0.75 mg/kg, was administered, and the response to 10 minutes of N2O again observed. N2O did not change vascular resistance in the isolated lobe, but increased intact-lung PVR.(ABSTRACT TRUNCATED AT 250 WORDS)