Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Review Meta AnalysisDesflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials.
The authors performed a meta-analysis to investigate whether the cardioprotective effects of volatile anesthetics translate into decreased morbidity and mortality in patients undergoing cardiac surgery. ⋯ Desflurane and sevoflurane have cardioprotective effects that result in decreased morbidity and mortality. The present data show for the first time that the choice of an anesthetic regimen based on administration of halogenated anesthetics is associated with a better outcome after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Randomized Controlled Trial Comparative StudyCerebral near-infrared spectroscopy in adult patients after cardiac surgery is not useful for monitoring absolute values but may reflect trends in venous oxygenation under clinical conditions.
Cerebral near-infrared spectroscopy (NIRS) was evaluated for use in monitoring global oxygenation in adult patients after cardiac surgery. ⋯ Cerebral NIRS in adult patients might not be the tool to replace mixed venous oxygen monitoring. Further work has to be done to assess its potential to reflect intraindividual trends.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Randomized Controlled Trial Comparative StudyParasternal intercostal block with ropivacaine for pain management after cardiac surgery: a double-blind, randomized, controlled trial.
The purpose of this study was to test the hypothesis that administration of a parasternal intercostal block using ropivacaine 0.75% improved analgesia in postoperative cardiac surgical patients. ⋯ A ropivacaine parasternal intercostal block is a safe, simple, and effective adjunct for optimizing of pain control and reducing opioid analgesics after adult cardiac surgery. This study provides clinicians with an effective treatment for sternal wound pain.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Comparative StudyTransmitral flow propagation velocity and assessment of diastolic function during abdominal aortic aneurysm repair.
In the perioperative arena, pronounced changes in cardiac loading conditions can make assessment of diastolic parameters difficult. A number of Doppler techniques have been introduced to assess perioperative diastolic function. ⋯ Vp assessment identified the majority (93%) of cases of diastolic dysfunction identified by traditional methods. Furthermore, the incidence of diastolic dysfunction increased with application of the AXC but returned to baseline after removal.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Comparative StudyInferior vena cava diameter and central venous pressure correlation during cardiac surgery.
The purpose of this study was to determine whether a relationship exists between the inferior vena cava diameter (IVCD) or the superior vena cava diameter (SVCD) measured at the point of entry into the right atrium using transesophageal echocardiography (TEE) and the central venous pressure (CVP) under different experimental conditions. ⋯ A strong correlation between TEE-derived IVCD measured at the point of entry into the right atrium and CVP was observed in cardiac surgical patients when CVP was