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coronary bypass anesthesia

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https://www.readbyqxmd.com/read/28298766/comparison-of-perioperative-thoracic-epidural-fentanyl-with-bupivacaine-and-intravenous-fentanyl-for-analgesia-in-patients-undergoing-coronary-artery-bypass-grafting-surgery
#1
Amitabh Chanchal Sen, Sunil Rajan, Rakhi Balachandran, Lakshmi Kumar, Suresh Gangadharan Nair
CONTEXT: Two-thirds of patients undergoing coronary artery bypass grafting (CABG) surgery report moderate to severe pain, particularly with ambulatory or respiratory effort. AIMS: The aim of this study is to compare the analgesic effect of perioperative thoracic epidural fentanyl with bupivacaine and intravenous fentanyl in patients undergoing CABG surgery. SETTINGS AND DESIGN: The study was a prospective, randomized, nonblinded comparative study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28268929/cardiovascular-interactions-assessed-via-conditional-joint-transfer-entropy-in-patients-developing-atrial-fibrillation-after-coronary-artery-bypass-graft-surgery
#2
Vlasta Bari, Marco Ranucci, Andrea Marchi, Beatrice De Maria, Valeria Pistuddi, Alberto Porta
Assigned the universe of knowledge Ω as composed by one target and two exogenous signals, the conditional joint transfer entropy (CJTE), assessing the amount of information jointly transferred from the two sources to the target that can be uniquely linked to one of the two sources, was found useful to study cardiovascular control. We propose the assessment of CJTE from systolic arterial pressure (SAP) and respiration (R) to heart period (HP) conditioned on R (CJTESAP, R→HP|R) along the baroreflex, and from HP and R to SAP conditioned on R (CJTEHP, R→SAP|R) along the feedforward mechanical pathway, in 134 patients undergoing coronary artery bypass graft surgery before (PRE) and after (POST) the induction of general anesthesia...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227134/cardiovascular-interactions-assessed-via-conditional-joint-transfer-entropy-in-patients-developing-atrial-fibrillation-after-coronary-artery-bypass-graft-surgery
#3
Vlasta Bari, Marco Ranucci, Andrea Marchi, Beatrice De Maria, Valeria Pistuddi, Alberto Porta, Vlasta Bari, Marco Ranucci, Andrea Marchi, Beatrice De Maria, Valeria Pistuddi, Alberto Porta, Vlasta Bari, Andrea Marchi, Alberto Porta, Valeria Pistuddi, Beatrice De Maria, Marco Ranucci
Assigned the universe of knowledge Ω as composed by one target and two exogenous signals, the conditional joint transfer entropy (CJTE), assessing the amount of information jointly transferred from the two sources to the target that can be uniquely linked to one of the two sources, was found useful to study cardiovascular control. We propose the assessment of CJTE from systolic arterial pressure (SAP) and respiration (R) to heart period (HP) conditioned on R (CJTESAP, R→HP|R) along the baroreflex, and from HP and R to SAP conditioned on R (CJTEHP, R→SAP|R) along the feedforward mechanical pathway, in 134 patients undergoing coronary artery bypass graft surgery before (PRE) and after (POST) the induction of general anesthesia...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28217069/can-ultrasound-guided-subcostal-transverse-abdominis-plane-block-be-used-as-sole-anesthetic-technique
#4
Pooja Bihani, Pradeep Bhatia, Swati Chhabra, Pradeepika Gangwar
Subcostal transverse abdominis plane (TAP) block anesthetizes area of the abdomen with cutaneous innervation of T6-T10 dermatomes. These abdominal field blocks become very advantageous when cardiac patient presents for noncardiac surgeries as sole anesthetic or as a part of multimodal anesthesia. A 58-year-male came for open surgical repair of subxiphoid incisional hernia developed post coronary artery bypass grafting (CABG). Echocardiography showed hypokinesia of left ventricle (LV) in the left anterior descending (LAD) artery territory, dilated LV, and ejection fraction of 30%, and coronary angiography after 6 months of CABG showed 70% stenosis of LAD...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#5
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28169983/effect-of-preoperative-inspiratory-muscle-training-on-alveolar-arterial-oxygen-gradients-after-coronary-artery-bypass-surgery
#6
Khalid Turky, Amera M Abdelaziz Afify
PURPOSE: Gas exchange abnormalities and inspiratory muscle dysfunction are common postoperative pulmonary complications after cardiac surgery. The aim of this study was to investigate the changes in the alveolar arterial oxygen gradients and inspiratory muscle power after preoperative inspiratory muscle training (IMT) followed by postoperative IMT and early mobilization after coronary artery bypass graft surgery. METHODS: Patients were randomly assigned to the intervention group (n = 20) or the usual care group (n = 20)...
February 6, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28078857/effects-of-sevoflurane-on-cardiopulmonary-function-in-patients-undergoing-coronary-artery-bypass
#7
RANDOMIZED CONTROLLED TRIAL
J Zhang, S Wang
The objective of the current study was to investigate effects of sevoflurane on cardiopulmonary function in patients undergoing coronary artery bypass grafting (CABG). In this study, 60 cases of patients with coronary heart disease (CHD) were selected and randomly divided into the sevoflurane group (group S) and the control group C (group C) with 30 cases in each group. The two groups received intravenous anesthesia. The patients of group C were only given oxygen mask and physiological saline to keep vein open; while the patients of group S were administered with 1% sevoflurane immediately after the beginning of cardiopulmonary bypass (CPB) until the end of the treatment...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28074788/comparison-of-two-doses-of-heparin-on-outcome-in-off-pump-coronary-artery-bypass-surgery-patients-a-prospective-randomized-control-study
#8
RANDOMIZED CONTROLLED TRIAL
Murali Chakravarthy, Dattatreya Prabhakumar, Patil Thimmannagowda, Jayaprakash Krishnamoorthy, Antony George, Vivek Jawali
INTRODUCTION: While off pump coronary artery bypass surgery is practiced with an intention to reduce the morbidity associated with cardiopulmonary bypass, the resultant 'hypercoagulability' needs to be addressed. Complications such as cavitary thrombus possibly due to the hyper coagulability after off pump coronary artery bypass surgery have been described. Many clinicians use higher doses of heparin - up to 5 mg/kg in order to thwart this fear. Overall, there appears to be no consensus on the dose of heparin in off pump coronary artery bypass surgeries...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27906091/impact-of-prophylactic-administration-of-levosimendan-on-short-term-and-long-term-outcome-in-high-risk-patients-with-severely-reduced-left-ventricular-ejection-fraction-undergoing-cardiac-surgery-a-retrospective-analysis
#9
Philippe Grieshaber, Stella Lipp, Andreas Arnold, Gerold Görlach, Matthias Wollbrück, Peter Roth, Bernd Niemann, Jochen Wilhelm, Andreas Böning
BACKGROUND: Patients with severely reduced left-ventricular ejection fraction carry a high risk of morbidity and mortality after cardiac surgery. Levosimendan can be used prophylactically in these patients having shown positive effects on short-term outcome. However, effects on long-term outcome and patient subgroups benefiting the most are unknown. We aim to address these topics with real-life data from our clinical practice. METHODS: Two hundred eigthy eight patients with preoperative LVEF ≤ 35% underwent cardiac surgery with cardiopulmonary bypass between 2009 and 2013...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27795837/effects-of-low-dose-selenium-on-the-inflammatory-response-in-coronary-artery-bypass-graft-surgery-a-clinical-trial
#10
Abbas Sedighinejad, Vali Imantalab, Ali Mirmansouri, Ali Mohammadzadeh Jouryabi, Gholamreza Kanani, Nassir Nassiri Sheikhani, Mohammad Haghighi, Zahra Atrkarroushan, Gelareh Biazar
BACKGROUND: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. It is suggested that selenium (Se), an essential trace element, has a protective role against oxidative stress. Decreased intraoperative Se levels might be an independent predictive factor for postoperative multiorgan failure. In spite of its proposed advantages, however, the optimal timing and dosage are not well known...
August 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/27790356/moderate-hypothermia-and-its-effects-in-reducing-the-applied-dose-of-anesthetics-for-patients-with-opium-dependence-in-cardiac-surgery-a-randomized-controlled-trial
#11
Reza Jalaian Taghadomi, Ebrahim Golmakani, Kambiz Alizadeh, Behrooz Mottahedi, Ali Rahdari, Shima Sheybani
BACKGROUND: An increasing number of patients addicted to opium are experiencing awareness during coronary artery bypass surgery (CABG) as a result of tolerance to anesthetics. OBJECTIVES: This research was primarily intended to determine the potential diminishing effects of moderate hypothermia on anesthetic dosage and recall of anesthesia during the procedure. METHODS: In this double-blind randomized controlled trial, a total of 80 CABG candidates with known addiction to opium were divided into two groups: one normothermic (N) and the other moderately hypothermic (H), both undergoing induction as well as close monitoring from September 2014 to January 2016...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27778188/changes-in-intraocular-pressure-during-cardiopulmonary-bypass
#12
Fadime Nuhoglu, Funda Gumus, S Nadir Sinikoglu, Abdulkadir Yektas, Kerem Erkalp, Aysin Alagol
PURPOSE: The aim of the present study was to investigate the changes in intraocular pressures (IOP) in patients who underwent pulsatile and non-pulsatile cardiopulmonary bypass (CPB). METHODS: A total of 42 patients operated for elective coronary bypass surgery (CABG) on CPB were randomly allocated to pulsatile (Group P) and non-pulsatile (Group N) groups. Pulsatile flow was applied to Group P patients during crops-clamp period. The IOP measurements were made before and after the induction of anesthesia, before the onset of CPB, on the 5th, 15th, 30th, 45th, and 60th min of CPB, after CPB and at the end of the operation...
October 24, 2016: International Ophthalmology
https://www.readbyqxmd.com/read/27737403/dexmedetomidine-as-an-anesthetic-adjuvant-in-cardiac-surgery-a-cohort-study
#13
Paulo Gabriel Melo Brandão, Francisco Ricardo Lobo, Serginando Laudenir Ramin, Yasser Sakr, Mauricio Nassau Machado, Suzana Margareth Lobo
Objective: α-2-agonists cause sympathetic inhibition combined with parasympathetic activation and have other properties that could be beneficial during cardiac anesthesia. We evaluated the effects of dexmedetomidine as an anesthetic adjuvant compared to a control group during cardiac surgery. Methods: We performed a retrospective analysis of prospectively collected data from all adult patients (> 18 years old) undergoing cardiac surgery. Patients were divided into two groups, regarding the use of dexmedetomidine as an adjuvant intraoperatively (DEX group) and a control group who did not receive α-2-agonist (CON group)...
May 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27660748/the-effect-of-pre-emptive-dexmedetomidine-on-the-incidence-of-post-thoracotomy-pain-syndrome-in-patients-undergoing-coronary-artery-bypass-grafting
#14
Morteza Jabbary Moghaddam, Ali Barkhori, Alireza Mirkheshti, Morteza Hashemian, Seyed Amir Mohajerani
BACKGROUND: Post-thoracotomy pain syndrome (PTPS) is pain that recurs or persists along a thoracotomy incision for at least two months following surgery. Dexmedetomidine (dex) is an α-2 agonist that also has analgesic, sedative-hypnotic, and sympatholytic properties. OBJECTIVES: To determine the effect of pre-emptive dexmedetomidine on the incidence of PTPS in patients undergoing coronary artery bypass grafting (CABG). PATIENTS AND METHODS: This randomized clinical trial enrolled 104 candidates for elective coronary artery bypass grafting (CABG) and randomly assigned them to either a dex group or a control group...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27642569/the-effect-of-green-tea-gargle-solution-on-sore-throat-after-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#15
Hedayat Jafari, Mohammad Reza Ariaeifar, Jamshid Yazdani Charati, Aria Soleimani, Ebrahim Nasiri Formi
BACKGROUND: Tracheal intubation is an essential method of keeping the airway open in patients under general anesthesia. Sore throat is a prevalent complication after endotracheal intubation. OBJECTIVES: The aim of this study was to investigate the effect of green tea gargling on sore throat after coronary artery bypass grafting (CABG). PATIENTS AND METHODS: This was a single-blind, randomized clinical trial, in which 121 patients who had undergone CABG were divided into two groups: those who gargled distilled water and those who gargled a green tea solution...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27619328/left-main-coronary-artery-atresia-in-an-infant-with-inclusion-cell-disease
#16
Rachel L Bounds, Joseph Kuebler, Jill M Cholette, George M Alfieris, Sitaram M Emani, Carol A Wittlieb-Weber
A 2-month-old male with dysmorphic facies, neonatal thrombocytopenia, left congenital cataract, and long bone abnormalities became hypotensive with ST depression on induction of anesthesia for congenital cataract repair. Echocardiogram demonstrated decreased left ventricular function (ejection fraction 46%), mild mitral valve regurgitation (MR), and regional wall motion abnormalities. The left coronary artery could not be visualized. Subsequent cardiac catheterization confirmed atresia of the left main coronary artery...
September 12, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27604392/combined-transcatheter-aortic-valve-implantation-and-type-ii-endoleak-repair-after-endovascular-repair-for-abdominal-aortic-aneurysm
#17
Yu Horiuchi, Mika Izumo, Takayoshi Kusuhara, Motoi Yokozuka, Takeshi Taketani, Kengo Tanabe
This report describes an elderly severe aortic stenosis (AS) patient, who had a history of coronary artery bypass grafting and endovascular repair for an abdominal aortic aneurysm (AAA). Type II endoleak with enlargement of AAA was diagnosed and ligation of inferior mesenteric artery (IMA) was recommended. Because aortic valve replacement (AVR) was high risk, we planned transcatheter aortic valve implantation (TAVI). Considering risks of IMA ligation under dual antiplatelet therapy, increased blood pressure after TAVI, and general anesthesia, we performed combined TAVI and IMA ligation...
September 7, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27555146/ultrashort-acting-remifentanil-is-not-superior-to-long-acting-sufentanil-in-preserving-cognitive-function-a-randomized-study
#18
RANDOMIZED CONTROLLED TRIAL
Linda A Rasmussen, Pia K Ryhammer, Jacob Greisen, Rajesh R Bhavsar, Anne-Grethe Lorentzen, Carl-Johan Jakobsen
STUDY OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27546830/echocardiographic-predictors-of-immediate-postoperative-outcomes-in-patients-with-severe-left-ventricular-systolic-dysfunction-undergoing-on-pump-coronary-artery-bypass-grafting
#19
Ajay Kumar Jha, Vishwas Malik, Parag Gharde, Sandeep Chauhan, Usha Kiran, Milind P Hote
OBJECTIVES: The postoperative course following on-pump coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction is often unpredictable. Therefore, the aim of this study was to identify predictors of poor postoperative outcome in this subset of patients. DESIGN: Prospective observational study SETTING: Single university hospital PARTICIPANTS: Forty patients with severe LV systolic dysfunction undergoing isolated on-pump CABG INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Comprehensive transesophageal echocardiographic examination was performed to obtain the indices of systolic and diastolic LV function after induction of anesthesia...
April 29, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27465213/comparison-of-isoflurane-and-sevoflurane-in-cardiac-surgery-a-randomized-non-inferiority-comparative-effectiveness-trial
#20
RANDOMIZED CONTROLLED TRIAL
Philip M Jones, Daniel Bainbridge, Michael W A Chu, Philip S Fernandes, Stephanie A Fox, Ivan Iglesias, Bob Kiaii, Ronit Lavi, John M Murkin
PURPOSE: Volatile anesthetics possess cardioprotective properties, but it is unknown if the cardioprotective effects extend equally to all members of the class. Although sevoflurane is a relatively newer anesthetic than isoflurane, its introduction into practice was not preceded by a head-to-head comparison with isoflurane in a trial focusing on clinically important outcomes. Our objective was to determine whether sevoflurane was non-inferior to isoflurane on a clinically important primary outcome in a heterogeneous group of adults undergoing cardiac surgery...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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