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Left ventricular end-diastolic pressure response to spinal anaesthesia in euvolaemic vascular surgery patients.
Gkounti, Georgia; Loutradis, Charalampos; Katsioulis, Christos; Nevras, Vasileios; Tzimou, Myrto; Pitoulias, Apostolos G; Argiriadou, Helena; Efthimiadis, Georgios; Pitoulias, Georgios A.
Afiliación
  • Gkounti G; Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece. g-goudi@hotmail.com.
  • Loutradis C; Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece.
  • Katsioulis C; Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece.
  • Nevras V; Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece.
  • Tzimou M; Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece.
  • Pitoulias AG; Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece.
  • Argiriadou H; School of Health Sciences, Faculty of Medicine, Department of Anesthesia and Intensive Care, Aristotle University of Thessaloniki, Thessaloniki, Greece.
  • Efthimiadis G; School of Health Sciences, Faculty of Medicine, First Cardiology Department, Cardiomyopathies Center, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.
  • Pitoulias GA; School of Health Sciences, Faculty of Medicine, Second Department of Surgery - Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece.
J Clin Monit Comput ; 2024 Sep 21.
Article en En | MEDLINE | ID: mdl-39305452
ABSTRACT

PURPOSE:

Regional anaesthesia techniques provide highly effective alternative to general anaesthesia. Existing evidence on the effect of spinal anaesthesia (SA) on cardiac diastolic function is scarce. This study aimed to evaluate the effects of a single-injection, low-dose SA on left ventricular end-diastolic pressures (LVEDP) using echocardiography in euvolaemic patients undergoing elective vascular surgery.

METHODS:

This is a prospective study in adult patients undergoing elective vascular surgery with SA. Patients with contraindications for SA or significant valvular disease were excluded. During patients' evaluations fluid administration was targeted using arterial waveform monitoring. All patients underwent echocardiographic studies before and after SA for the assessment of indices reflective of diastolic function. LVEDP was evaluated using the E/e' ratio. Blood samples were drawn to measure troponin and brain natriuretic peptide (BNP) levels before and after SA.

RESULTS:

A total of 62 patients (88.7% males, 71.00 ± 9.42 years) were included in the analysis. In total population, end-diastolic volume (EDV, 147.51 ± 41.36 vs 141.72 ± 40.13 ml; p = 0.044), end-systolic volume (ESV, 69.50 [51.50] vs 65.00 [29.50] ml; p < 0.001) and E/e' ratio significantly decreased (10.80 [4.21] vs. 9.55 [3.91]; p = 0.019). In patients with elevated compared to those with normal LVEDP, an overall improvement in diastolic function was noted. The A increased (- 6.58 ± 11.12 vs. 6.46 ± 16.10; p < 0.001) and E/A decreased (0.02 ± 0.21 vs. - 0.36 ± 0.90; p = 0.004) only in the elevated LVEDP group. Patients with elevated LVEDP had a greater decrease in E/e' compared to those with normal LVEDP (- 0.03 ± 2.39 vs. - 2.27 ± 2.92; p = 0.002).

CONCLUSION:

This study in euvolaemic patients undergoing elective vascular surgery provides evidence that SA improved LVEDP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Monit Comput Asunto de la revista: INFORMATICA MEDICA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Monit Comput Asunto de la revista: INFORMATICA MEDICA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Países Bajos