Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2001
Clinical TrialPlatelet glass bead retention predicts bleeding after cardiac surgery.
To determine if the platelet glass bead retention assay can predict bleeding after cardiac surgery. ⋯ The platelet glass bead retention assay measures dynamic platelet function and is sensitive to the CPB-induced adhesion and aggregation defect and correlates with postoperative blood loss. Modification of this platelet function assay used with the prothrombin time may provide a simple and effective diagnostic approach to bleeding after CPB.
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J. Cardiothorac. Vasc. Anesth. · Dec 2000
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of fentanyl and sufentanil in patients undergoing coronary artery bypass graft surgery.
To compare fentanyl and sufentanil, administered in equipotent concentrations by target-controlled infusion, as components of a balanced anesthetic in patients undergoing coronary artery bypass graft (CABG) surgery. ⋯ When administered in a constant 10:1 concentration ratio, fentanyl and sufentanil do not differ in their ability to facilitate pre-CPB hemodynamic control. Although both opioids were relatively inexpensive, the acquisition cost of fentanyl was less than sufentanil. A recommendation regarding the opioid of choice for routine use in patients undergoing CABG surgery awaits more rigorous studies of recovery and cost after equipotent doses of fentanyl and sufentanil. When combined with isoflurane, effect-site opioid concentrations near the IC50 for electroencephalographic effect provide excellent pre-CPB hemodynamic control in patients undergoing CABG surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2000
Clinical TrialPreliminary report on high thoracic epidural analgesia: relationship between its therapeutic effects and myocardial blood flow as assessed by stress thallium distribution.
To extend the duration of high thoracic epidural analgesia (HTEA) treatment compared with the authors' previous studies, to test the hypothesis that the mechanism by which HTEA reduces angina during long-term treatment includes an improvement in myocardial blood flow distribution and a reduction in stress-induced ischemia, and to show that new myocardial infarctions are not masked or missed in patients receiving HTEA. ⋯ The authors previously showed that HTEA is safe and effective in relieving refractory angina pectoris. The current study shows that this therapeutic effect persists and does not appear to be related to a change in myocardial blood flow; rather the improvement in symptoms probably results, in part, from an anesthetic effect. HTEA does not mask the development of new myocardial infarctions.