Articles: postoperative-complications.
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J. Am. Coll. Cardiol. · Jun 1985
Esmolol: a new ultrashort-acting beta-adrenergic blocking agent for rapid control of heart rate in postoperative supraventricular tachyarrhythmias.
Prompt control of heart rate is important for successful treatment of supraventricular tachyarrhythmias early after open heart surgery when sympathetic tone is high and ventricular response rates may be rapid. Esmolol, a new ultrashort-acting (9 minute half-life) beta-receptor blocking agent, was given by continuous intravenous infusion for up to 24 hours in 24 patients (21 with isolated coronary bypass surgery and 3 with valve replacement) 1 to 7 days after surgery. Atrial fibrillation was present in 9 patients, atrial flutter in 2 and sinus tachycardia in 13. ⋯ Within 5 to 18 minutes after initiation of therapy, all patients had achieved a 15% reduction in heart rate at a maintenance dose of 150 micrograms/kg per min or less. A 20% reduction in heart rate was attained in 19 of the 24 patients, and conversion to sinus rhythm occurred during esmolol infusion in 5 of the 11 patients with atrial flutter or fibrillation. Transient asymptomatic hypotension (less than 90/50 mm Hg) was seen in 13 patients, requiring cessation of esmolol therapy in 2.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia progress · May 1985
Case ReportsPostoperative delirium secondary to atropine premedication.
Anticholinergic agents used as preoperative medications have the ability to induce postanesthetic delirium reactions. We present a case of postanesthetic delirium secondary to premedication with atropine which was treated with intravenous physostigmine. This case is presented to alert the clinician to the possibility of this reaction occurring with the use of atropine, and to demonstrate the use of physostigmine in reversing postanesthetic delirium reactions caused by anticholinergics.
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Beware anesthesiologist number 7... the quality of intraoperative conduct of anesthesia effects patient outcomes.
pearl