R. S. Achurin, M. G. Lepilin, A. Bajalieva, S. V. Torshin, P. M. Lepilin

Peculiarities of Hemodynamic Changes During High Thoracic Epidural Anesthesia in Beating Heart Surgery

Anahtar Kelimeler:

-

Peculiarities of Hemodynamic Changes During High Thoracic Epidural Anesthesia in Beating Heart Surgery

Aim: Myocardial protection during off-pump coronary artery bypass surgery is a multifactorial problem. Careful, individualized choice of graft sequence and maintenance of stable systemic hemodynamics are of central importance. Patients with coronary artery disease have a high risk of adverse cardiac outcome during and after surgery. Thoracic epidural anesthesia (TEA) aims at a more specific reversible blockade of cardiac sympathetic efferents provides effective intra- and postoperative analgesia. Methods: 82 patients (mean age 69.2±14 years) undergoing off-pump coronary surgery have been divided into 2 groups (traditional general anesthesia (50), TEA combined anesthesia (32) (Naropin). Results: In the TEA group heart rate (HR) was low (12.6%, p

Keywords:

-,

PDF

___

Penttilä HJ, Lepojärvi MVK, Kiviluoma KT et al. Myocardial preservation during coronary surgery with and without cardiopulmonary bypass. Ann Thoracic Surg 2001;71:565-70
Aybek T, Kessler P, Khan MF et al. Operative techniques in awake coronary bypass grafting. Thorac Cardiovasc Surg 2003;125:1395-400
Ares K. Menon, Johannes M. Albes et al. Occlusion versus shunting during MIDCAB: effects on left ventricular function and quality of anastomosis. Ann Thorac Surg 2002;73:1418-23
Puskas JD, Vinten-Johansen J, Muraki S, Guyton RA. Myocardial protection for off-pump coronary artery bypass surgery. Semin in Thorac Cardiovasc Surg 2001;13:82-8
Guyton RA, Thourani VH, Puskas JD, et al. Perfusion-assisted direct coronary artery bypass: Selective graft perfusion in off-pump cases. Ann Thorac Surg 2000; 69:171-75
Royse C, Royse AG, Soeding P. et al. Prospective randomized trial of high thoracic epidural analgesia for coronary artery bypass surgery. Ann Thorac Surg 2003;75:93-100