Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2005
Randomized Controlled Trial Comparative StudyA prospective, double-blind, randomized, placebo-controlled study of dexmedetomidine as an adjunct to epidural analgesia after thoracic surgery.
The purpose of this study was to test the hypothesis that after thoracic surgery, the supplementation of a low-dose thoracic epidural (ED) bupivacaine (0.125%) infusion by intravenous (IV) dexmedetomidine decreases analgesic requirement without causing respiratory depression. The primary endpoint was the need for additional ED bupivacaine administered through patient-controlled epidural analgesia (PCEA). Secondary endpoints included the requirement for supplemental opioids and the impact of dexmedetomidine on CO2 retention. ⋯ The authors conclude that in postthoracotomy patients, IV dexmedetomidine is a potentially effective analgesic adjunct to thoracic ED bupivacaine infusion and may decrease the requirement for opioids and potential for respiratory depression.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2005
Comparative StudyOctogenarians undergoing coronary artery bypass graft surgery: resource utilization, postoperative mortality, and morbidity.
The purpose of the present study was to examine resource utilization in octogenarians undergoing coronary artery bypass grafting (CABG) and compare it with usage in their younger cohorts at a tertiary care heart center. The resources examined were time to extubation, packed red blood cell transfusions, intensive care unit (ICU) length of stay (LOS), and preoperative and postoperative LOS. The study also examined differences in postoperative morbidity and mortality. ⋯ The results demonstrated that octogenarians undergoing CABG required increased resource utilization and had significantly higher morbidity, with increased incidence of postoperative renal failure, neurologic complications, and 30- day mortality. Age 80 years or older was an independent predictor of increased resource utilization, postoperative morbidity, and mortality.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2005
Comparative StudyAnesthesia for port-access cardiac surgery in a pediatric population.
A less invasive approach to cardiac surgical procedures has become widely accepted. The Port-Access (Heartport Inc, Redwood City, CA) technique for correction of acquired and congenital heart defects in adults produces superior cosmetic results without increasing perioperative morbidity. This study evaluated the feasibility of the Port-Access approach for repairs of various congenital heart defects in children and describes the anesthetic management for this procedure. ⋯ The Port-Access method for the correction of selected congenital cardiac defects is feasible in children.