Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Early effects of coronary artery bypass surgery and cold cardioplegic ischemia on left ventricular diastolic function: evaluation by computer-assisted transesophageal echocardiography.
Although left ventricular (LV) systolic function undergoes a temporary decrease after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG), data on the effects of CABG and cardioplegic arrest on LV diastolic function are contradictory. The objective of the present study was to further evaluate the effects of CABG and CPB on LV diastolic function. ⋯ Both the active and passive components of LV diastolic function are well maintained shortly after CABG and cardioplegic arrest in patients with a good preoperative systolic LV function.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialContinuous infusion is superior to bolus doses with thoracic paravertebral blocks after thoracotomies.
This study was designed to determine whether a continuous thoracic paravertebral infusion of bupivacaine (continuous TPVI) offers a higher quality of analgesia than a bolus regimen after thoracotomy. ⋯ Results suggest that continuous TPVI provides better pain control than the bolus regimen after this kind of surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparative effects of plain and epinephrine-containing bupivacaine on the hemodynamic response to cervical plexus anesthesia in patients undergoing carotid endarterectomy.
This study was designed to investigate whether the addition of epinephrine as a vasoconstrictor additive to local anesthetic affects the hemodynamic profile after cervical plexus block in patients presenting for carotid endarterectomy. ⋯ Concerning cervical plexus block with bupivacaine, the use of epinephrine is associated with an increase in heart rate consistent with a beta-adrenergic effect from systemic absorption of the epinephrine. An increase in systolic blood pressure independent of the use of epinephrine also occurs, but epinephrine appears to mitigate against an increase in diastolic blood pressure.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Clinical TrialEffects of positive end-expiratory pressure ventilation on splanchnic oxygenation in humans.
To examine the influence of positive end-expiratory pressure (PEEP) ventilation on splanchnic oxygenation and lactate production in humans without pulmonary disorders. ⋯ Ventilation with PEEP causes reductions in CO and MAP, resulting in a comparable impairment of systemic and splanchnic oxygen. The absence of changes in lactate concentrations indicates that a critical reduction in systemic and splanchnic oxygenation is unlikely during ventilation with low or high PEEP levels.