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Arrhythmia and anaesthesia

Bon Sebastian, Anand T Talikoti, Dinesh Krishnamurthy
BACKGROUND AND AIMS: Laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing tachycardia, arrhythmias and hypertension. The aim of this study was to arrive at an optimal dose of dexmedetomidine by comparing two doses with placebo to attenuate stress response during laryngoscopy and endotracheal intubation. METHODS: It was a randomised, prospective, double-blind placebo-controlled study. After Institutional Ethical Committee clearance, ninety patients of American Society of Anesthesiologists Physical Status 1 were enrolled in the study and divided into three equal groups...
January 2017: Indian Journal of Anaesthesia
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
S H Lee, H J Ahn, S M Yeon, M Yang, J A Kim, D M Jung, J H Park
Atrial fibrillation is the most frequent arrhythmia after thoracic surgery and is associated with increased hospital costs, morbidity and mortality. In this study, we aimed to identify potentially modifiable risk factors for postoperative atrial fibrillation following lung resection surgery and to suggest possible measures to reduce risk. We retrospectively reviewed the medical records of 4731 patients who underwent lobectomy or more major lung resection over a 6-year period. Patients who developed atrial fibrillation postoperatively and required treatment were included in the postoperative atrial fibrillation group, while the remaining patients were assigned to the non-postoperative atrial fibrillation group...
December 2016: Anaesthesia
Matthew Cauldwell, Kate Von Klemperer, Anselm Uebing, Lorna Swan, Philip J Steer, Michael Gatzoulis, Mark R Johnson
OBJECTIVE: To examine the duration of the passive and active parts of the second stage (SS) of labour in women with cardiac disease (CD) and to assess the adherence to antenatal care plans regarding timing of assisted delivery. Cardiac parameters were measured in a subset of women to investigate any differences between the passive and active SS of labour. STUDY DESIGN: Cohort study of 73 women with CD, classified into mWHO Class Groups I-IV. Women were matched with an equal number of women controlling for gestational age, maternal age (+/- five years), parity, use of regional anaesthesia, and spontaneous versus assisted delivery...
November 1, 2016: International Journal of Cardiology
Snjezana Zeba, Maja Surbatović, Milan Marjanović, Jasna Jevdjić, Zoran Hajduković, Radovan Karkalić, Dalibor Jovanović, Sonja Radaković
BACKGROUND/AIM: Hypothermia in surgical patients can be the consequence of long duration of surgical intervention, general anaesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, and prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition. The aim of this study was to evaluate the efficiency of external warming system in alleviation of cold stress and hypothermia in patients who underwent major surgical procedures...
June 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
August 4, 2016: Cochrane Database of Systematic Reviews
Mustafa Özgür, Ayhan Köseoğlu
Long QT syndrome is a cardiac repolarisation disorder that can occur with clinical symptoms such as dizziness, fainting, life-threatening arrhythmias and sudden cardiac death, and its incidence is increasing in the general population. A careful anaesthetic management is required for patients with this syndrome because of the risk of torsades de pointes and malignant arrhythmias. In this case report, we discuss the anaesthetic management of a seven-year-old patient with congenital long QT syndrome that was diagnosed during the preoperative evaluation...
April 2016: Turkish Journal of Anaesthesiology and Reanimation
Nicolas Chudeau, Tommy Raveau, Laurence Carlier, Damien Leblanc, Guillaume Bouhours, Frédéric Gagnadoux, Emmanuel Rineau, Sigismond Lasocki
INTRODUCTION: The STOP-BANG (SB) questionnaire, a tool originally proposed for identifying patients at risk of obstructive sleep apnoea, may also identify patients at increased risk of perioperative complications (when>3). Perioperative complications, including respiratory ones, are more frequent in emergency surgery. This study aimed at evaluating whether the SB is predictive of perioperative respiratory complications in urgent surgery. METHODS: Consecutive adult patients admitted for an urgent surgery under general anaesthesia were included...
October 2016: Anaesthesia, Critical Care & Pain Medicine
J Botman, F Gabriel, A H A Dugdale, J-M Vandeweerd
The objective of the study was to determine the minimal anaesthetic concentration (MAC) of sevoflurane (SEVO) in pigeons and investigate the effects of 1 MAC SEVO anaesthesia on cardiovascular and respiratory variables compared with the awake state. This is a prospective, experimental study. Animals were seven healthy adult pigeons. After acclimatisation to handling, heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (PE'CO2), inspired CO2 tension, indirect systolic arterial blood pressure (SAP) and cloacal temperature were measured to determine baseline, 'awake' values...
May 28, 2016: Veterinary Record
Jowita Biernawska, Jarosław Kaźmierczak, Katarzyna Kotfis, Maciej Żukowski
The normal function of the heart muscle is the result of electro-mechanic and hemodynamic coupling. Modification of the structure and activity of ion channels within the cardiomyocytes may induce cardiac arrhythmias. Electrophysiological mechanisms of arrhythmia, generated by a prolonged period of repolarization, result either from conduction disturbances (reentry mechanism) and/or the induction of beats (early after-depolarizations). Local anaesthetic drug deposition does not affect the repolarization period, as long as the concentration of the free drug in the plasma does not reach the critical value to cause toxic effects in the cardiomyocytes...
2016: Anaesthesiology Intensive Therapy
Hariharan Raju, John Whitaker, Carly Taylor, Matthew Wright
BACKGROUND: We evaluated Carto 3, transoesophageal echocardiography (TOE) and contact force (CF) sensing catheter in atrial fibrillation (AF) ablation. METHODS: Unselected consecutive ablations performed under general anaesthesia (GA) were studied with modified protocol (cases, n=11) and compared to retrospective consecutive controls (n=10). Patent foramen ovale (PFO) or single transseptal puncture enabled left atrial (LA) access; ablation strategy was stepwise approach...
July 2016: Heart, Lung & Circulation
Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
February 21, 2016: Cochrane Database of Systematic Reviews
M de la Flor-Robledo, P Solís-Muñoz, M Sanjuán-Álvarez, J M Abadal-Villayandre, F Asensio-Merino
Percutaneous irreversible electroporation (IRE) is a novel tumour ablation method. The application of short and high-voltage electrical pulses to the target lesion induces alterations in cell membrane permeability, finally causing tumour cell death. The extremely high-voltage that is needed in this technique requires the surveillance and management of an experienced anaesthesiologist, as it involves a significant risk of complications, such as cardiac arrhythmias or seizures. The case is presented of a 66 year-old patient diagnosed with a renal adenocarcinoma, and who received without intention-to-cure IRE under general anaesthesia...
August 2016: Revista Española de Anestesiología y Reanimación
M T Kiani, G Tajik, M Ajami, H Fazli, M J Kharazifard, A Mesgarzadeh
The Le Fort I osteotomy is performed under general anaesthesia and specific haemodynamic conditions, i.e. hypotensive general anaesthesia. This study assessed the incidence of the trigeminocardiac reflex (TCR) during the different stages of the Le Fort I osteotomy. Forty-seven patients requiring a Le Fort I osteotomy were included. General anaesthesia was induced. In terms of haemodynamic changes, each patient's oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR), and electrocardiogram (ECG) were monitored by SADAAT Monitoring System and recorded during the different stages of osteotomy: before the induction of anaesthesia, before osteotomy cuts, after finishing the right pterygoid plate osteotomy, after finishing the left pterygoid plate osteotomy, and after performing down-fracture of the maxilla...
May 2016: International Journal of Oral and Maxillofacial Surgery
B Oliván, A Arbeláez, M de Miguel, A Pelavski
Brugada syndrome is an autosomal dominant genetic disease affecting sodium ion channels. It is characterised by right bundle branch block and ST elevation in the right precordial leads, and with no structural cardiac abnormalities. It is associated with sudden death. This disease may be unmasked by certain drugs and sudden changes in autonomic tone. Local anaesthetics may increase ECG changes due to a blockade of the sodium channels, mainly depending on the dose and the type of anaesthetic. Thus, there have been reported electrocardiographic changes consistent with Brugada syndrome, triggered after epidural or paravertebral infusion of bupivacaine and ropivacaine...
October 2016: Revista Española de Anestesiología y Reanimación
María Mercedes López, Emilia Guasch, Renato Schiraldi, Genaro Maggi, Eduardo Alonso, Fernando Gilsanz
BACKGROUND AND OBJECTIVES: Aortic stenosis increases perioperative morbidity and mortality, perioperative invasive monitoring is advised for patients with an aortic valve area <1.0 cm(2) or a mean aortic valve gradient >30 mmHg and it is important to avoid hypotension and arrhythmias. We report the anaesthetic management with continuous spinal anaesthesia and minimally invasive haemodynamic monitoring of two patients with severe aortic stenosis undergoing surgical hip repair. CASE REPORT: Two women with severe aortic stenosis were scheduled for hip fracture repair...
January 2016: Brazilian Journal of Anesthesiology
Jiandong Ding, Jian Zhu, Jing Lu, Xiuxia Ding, Xiaoli Zhang, Wenbin Lu, Mingqiang Ao, Genshan Ma
BACKGROUND: Atrial fibrillation (AF) is the most commonly encountered clinical arrhythmia, accounting for approximately one third of hospitalizations for cardiac rhythm disturbance. In patients with non-valvular AF, approximately 90% of thrombi are thought to arise from the left atrial appendage (LAA). Anticoagulation with warfarin has been the mainstay of therapy to reduce stroke risk in these patients; however, it is not without its complications including bleeding and drug interactions...
2015: International Journal of Clinical and Experimental Medicine
Matthew McMillan, Hannah Darcy
OBJECTIVE: To develop, test and refine an 'intervention-based' system for the surveillance of adverse events (AEs) during small animal anaesthesia. STUDY DESIGN: Prospective, voluntary reporting audit. ANIMALS: A total of 1386 consecutive small animal anaesthetics (including 972 dogs and 387 cats). METHODS: Adverse events were defined as undesirable perianaesthetic events requiring remedial intervention to prevent or limit patient morbidity...
March 2016: Veterinary Anaesthesia and Analgesia
Bin Cui, Shuiyun Wang, Jianping Xu, Wei Wang, Yunhu Song, Hansong Sun, Zhe Zheng, Feng Lv, Hui Xiong
OBJECTIVES: The purpose of this retrospective study was to analyse the pathogenesis and the treatment strategies of hypertrophic obstructive cardiomyopathy (HOCM) with the concomitant mitral valve abnormalities. METHODS: Between October 1996 and December 2009, 76 patients with the HOCM underwent the ventricular septal myotomy-myectomy in Fuwai hospital. There were 51 males and 25 females aged between 6 and 68 years (mean: 37.18 ± 15.85 years) old. All the patients had left ventricular outflow tract (LVOT) obstruction with a resting or physically provoked gradient of ≥50 mmHg and the systolic anterior movement (SAM) of the mitral leaflets, and 64 patients had mitral regurgitation (MR)...
December 2015: Interactive Cardiovascular and Thoracic Surgery
Zhongheng Zhang, Xiaoyun Hu, Xia Zhang, Xiuqi Zhu, Liqian Chen, Li Zhu, Caibao Hu, Bin Du
OBJECTIVE: Protective ventilation (PV) has been validated in patients with acute respiratory distress syndrome. However, the effect of PV in patients undergoing major surgery is controversial. The study aimed to explore the beneficial effect of PV on patients undergoing a major operation by systematic review and meta-analysis. SETTING: Various levels of medical centres. PARTICIPANTS: Patients undergoing general anaesthesia. INTERVENTIONS: PV with low tidal volume...
2015: BMJ Open
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