RESUMO
INTRODUCTION: To obtain the optimal anesthesia depth is not easy in cardiovascular surgery patients where the haemodynamic reserve is limited, due to reasons such as not being able to give the desired dose of anesthetic agent, or the change in the pharmacokinetics of the agent in the heart-lung machine. This study was planned to assess the contribution of bispectral index (BIS) monitoring in the depth of anesthesia. METHODS: The patients were divided into 2 groups, and BIS monitoring was used for each patient. Group 1 (G1 n=35): keeping the BIS monitor screen open, the anesthesia need was set. Group 2 (G2 n=35): BIS monitor was tied to the patient and the monitor screen was closed in such a way that the anaesthesist couldn't see the BIS value. When the recording time came, the data on the monitor was recorded. The need for the anesthetic agent was set according to the parameters such as haemodynamics or follow up of pupils, instead of BIS value, by titrating the anesthetic infusion doses. RESULTS: BIS values were similar in both groups before the induction, BIS values in both groups showed a decrease, showing no significant statistical difference (P>0.05). One patient in each group said that he dreamt, and one patient in G2 said that he had heard a noise and felt that he was taken from one place to another. CONCLUSION: The management should be done with clinical evaluation, haemodynamics and other monitorization methods and BIS monitoring findings together.
Assuntos
Monitores de Consciência/estatística & dados numéricos , Ponte de Artéria Coronária/instrumentação , Consciência no Peroperatório/diagnóstico , Monitorização Intraoperatória/métodos , Idoso , Anestésicos Intravenosos/administração & dosagem , Monitores de Consciência/normas , Fentanila/administração & dosagem , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Monitorização Intraoperatória/estatística & dados numéricos , Propofol/administração & dosagemRESUMO
Abstract Introduction: To obtain the optimal anesthesia depth is not easy in cardiovascular surgery patients where the haemodynamic reserve is limited, due to reasons such as not being able to give the desired dose of anesthetic agent, or the change in the pharmacokinetics of the agent in the heart-lung machine. This study was planned to assess the contribution of bispectral index (BIS) monitoring in the depth of anesthesia. Methods: The patients were divided into 2 groups, and BIS monitoring was used for each patient. Group 1 (G1 n=35): keeping the BIS monitor screen open, the anesthesia need was set. Group 2 (G2 n=35): BIS monitor was tied to the patient and the monitor screen was closed in such a way that the anaesthesist couldn't see the BIS value. When the recording time came, the data on the monitor was recorded. The need for the anesthetic agent was set according to the parameters such as haemodynamics or follow up of pupils, instead of BIS value, by titrating the anesthetic infusion doses. Results: BIS values were similar in both groups before the induction, BIS values in both groups showed a decrease, showing no significant statistical difference (P>0.05). One patient in each group said that he dreamt, and one patient in G2 said that he had heard a noise and felt that he was taken from one place to another. Conclusion: The management should be done with clinical evaluation, haemodynamics and other monitorization methods and BIS monitoring findings together.
Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Ponte de Artéria Coronária/instrumentação , Monitorização Intraoperatória/métodos , Monitores de Consciência/estatística & dados numéricos , Consciência no Peroperatório/diagnóstico , Propofol/administração & dosagem , Fentanila/administração & dosagem , Monitorização Intraoperatória/estatística & dados numéricos , Anestésicos Intravenosos/administração & dosagem , Monitores de Consciência/normas , HemodinâmicaRESUMO
OBJECTIVE: This study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery. METHODS: Hundred fourty patients with a total of 361 grafts [205 (57%) arterial and 156 (43%) venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70) consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min), and Group B (n=70) didn't receive diltiazem infusion. RESULTS: Mean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P<0.001). Pulsatility index (PI) values of left internal mammary artery for Group A and Group B were 2.6 and 3.0 respectively (P<0.001). No statistically significant difference was found between venous graft parameters. CONCLUSION: We recommend an effect of diltiazem infusion in increasing graft flows in coronary artery bypass graft operations.