Cardiovascular Effects of Neurolept Anaesthesia in Patients with Coronary Artery Disease

Abstract

An anaesthetic technique comprising a combination of phenoperidine (0.1 mg . kg-1), diazepam (0.06 mg . kg-1) and pancuronium bromide (0.1 mg . kg-1) with controlled ventilation was evaluated in 12 patients with severe coronary artery disease. The heart rate, cardiac output and mean arterial blood pressure did not change significantly between the preinduction and postinduction measurements. The right atrial pressure and pulmonary capillary wedge pressure decreased significantly by 33% and 36%, respectively, probably due to the influence of positive-pressure ventilation. There was no depression of the left ventricular performance.

Comparison of Nitroprusside and Nitroglycerine for Controlling Hypertension During Coronary Artery Surgery

“…This beneficial effect has yet to be demonstrated in the presence of increased ventricular filling pressures in man. It would therefore seem logical to control hypertension during operation by the adoption of an anaesthetic technique which has a reputation for maintaining cardiovascular stability without depressing ventricular function (Tyden and Westerholm, 1979) by using moderate betablockade (by discontinuing beta-blocking agents 12-24h before surgery) and augmenting these with direct-acting vasodilators. Kaplan and Jones (1979) compared nitroprusside with nitroglycerine freshly prepared in the hospital pharmacy and showed that both drugs directly affect vascular smooth muscle and will decrease arterial pressure by a balanced dilation of resistance and capacitance vessels during anaesthesia.…”