Comparison of Effects of Balanced Anaesthesia and Neuroleptanalgesia on Postoperative Cardiovascular Function in Patients With Coronary Artery Disease

Abstract

Patients with chronic ischaemic heart disease and a history of myocardial infarction or who present with exertional or spontaneous angina suffer a decrease in left ventricular pump function during recovery from anaesthesia and in the period immediately after operation. This decrease is reflected in an increase in pulmonary capillary wedge pressure and in a decrease in stroke volume and cardiac output. Two groups of 10 such patients, clinically and haemodynamically comparable in the preoperative period, were studied: 10 patients received balanced anaesthesia, and 10 neuroleptanalgesia. The disturbance in left ventricular function was less pronounced with neuroleptanalgesia. A significant difference was noted between the groups with regard to pulmonary capillary wedge pressure during recovery from anaesthesia (balanced anaesthesia 15.8 +/- 4.4 mm Hg; neuroleptanalgesia 10.7 +/- 4.4 mm Hg; P less than 0.02). There was a relationship between type of anaesthesia and pulmonary capillary wedge pressure variations (P less than 0.01).