Tourniquet compression was released in group Ⅰ and Ⅱ,Ⅲ and Ⅳ at 30 s,60 s and 120 s after fentanyl injection,respectively,then rocuronium 0.6 mg/kg was injected intravenously in 10 s.
In group E, L1~2 epidural anesthesia was induced with 1.73% lidocaine carbonate to achieve a sensory level at T6. Fentanyl 0.1 mg iv was given before pneumoperitoneum;
Ulinastatin and apretinin were added to the priming solution before CPB.Anesthesia was induced and maintained with fentanyl,midazolam,propofol infusion and isoflurane inhalation. Blood samples were taken before CPB (Tt,baseline),5 min after aortic unclamping (T_2),30 min (T_3) and 4 h (T_4) after termination of CPB for determination of plasma concentrations of IL-6,IL-8,IL-10,TNF-a,cTnI and CK-MB activity.
Results The analgesic effect was satisfactory in ropivacaine group in postoperative 6 h, in Fentanyl transdermal system group in postoperative 6-48 h, and in postoperative 48 h in combination group.
Fifty-eight cases of multiple cardiac valves replacement were performed under intravenous balanced anesthesia. As the main anesthetic agents concerned, 41 oases received intravenous morphine, 12 cases droperidol-fentanyl and 5 cases diazepam-ketamine. All of those, suffered from valvular stenosis, regurgitation or combined, and those, associated with fixed low cardiac output, had their pathophysiology including hemodynamics altered a great deal; therefore the choice of anesthetics and adjuvants should...
Fifty-eight cases of multiple cardiac valves replacement were performed under intravenous balanced anesthesia. As the main anesthetic agents concerned, 41 oases received intravenous morphine, 12 cases droperidol-fentanyl and 5 cases diazepam-ketamine. All of those, suffered from valvular stenosis, regurgitation or combined, and those, associated with fixed low cardiac output, had their pathophysiology including hemodynamics altered a great deal; therefore the choice of anesthetics and adjuvants should be seriously considered.During the anesthesia, the use of vasoconstrictors has to be reduced to the least, vasodilators given freely whenever indicated and diuretics cancelled as a routine. For the monitorings and managements of anesthesia, basic principles have to be strictly followed.When the coronary blood-flow was interrupted for less than 90 minutes, 77.1 % of the operated hearts restored their beats spontaneously without electric shock. Nine cases died. Among them, one died during the induction stage and another 12 hours after surgery, both being considered to be due to poor experience. Causes of death for the remaining 7 cases died 4-39 days afterward, have also been analysed with brief discussion. Better post-operative intensive care may further reduce the surgical mortality
In the selection of the best drug for postoperative analgesia, the following drugs were injected respectively into retained continuous epidural block catheter, namely, pethidine 20mg(n=50), morphine 2mg(n=50), phenoperidine 0.2mg(n=25), fentanyl 0.02mg(n=25), fentanyl 0.05mg(n=25), saline 10ml(n=25) and cold saline 10ml(n=25). It was found that the duration of postoperative analgesia, 21.58±3.69 h, of morphine group was the longest, although the onset of analgesia, 7.89±2.21 rain, was slower. The...
In the selection of the best drug for postoperative analgesia, the following drugs were injected respectively into retained continuous epidural block catheter, namely, pethidine 20mg(n=50), morphine 2mg(n=50), phenoperidine 0.2mg(n=25), fentanyl 0.02mg(n=25), fentanyl 0.05mg(n=25), saline 10ml(n=25) and cold saline 10ml(n=25). It was found that the duration of postoperative analgesia, 21.58±3.69 h, of morphine group was the longest, although the onset of analgesia, 7.89±2.21 rain, was slower. The BP and pulse rate were not significantly changed, and no complications were encountered except 4 cases with urinary retention. The keys to the successful use of epidural morphine are epidural catheter at appropriate spinal segment, adequate volume(10 ml) of solution injected and adequate dose(2 mg) of morphine used.
6 cases of anesthetic management for valve reimplantation were reported.Acute valvular regurgitation occurred promptly after the rupture of heart bioprosthesis,heart failure and pulmonary edema might result.Maintenance of the cardiovascular stability was a matter of great importance before operation.All patients were inducted with sleeping dose of sodium pantothal,and the maintenance of anesthesia was carried out with fentanyl combining with N2O-O2 and pancuronium,except one case in which intravenous morphine...
6 cases of anesthetic management for valve reimplantation were reported.Acute valvular regurgitation occurred promptly after the rupture of heart bioprosthesis,heart failure and pulmonary edema might result.Maintenance of the cardiovascular stability was a matter of great importance before operation.All patients were inducted with sleeping dose of sodium pantothal,and the maintenance of anesthesia was carried out with fentanyl combining with N2O-O2 and pancuronium,except one case in which intravenous morphine was employed.The cardiovascular function was stable during operation,and no event was encountered.We believed that the balance anesthesia was the best choice in those patients.Principles of administration were recommanded as follows small dose and lower concentration.Any cardiac depression must be avoided,and patients could go well till the bypass.
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