Effect of Induction of Anesthesia and Ventilation on Ecg Signs of Ischemia in Patients With Acute Coronary Artery Insufficiency

Anaesthesia for Emergency Coronary Artery Surgery

“…It is not related to the anaesthetic agent administered or to the preoperative blood pressure. The increase in arterial pressure is reported (Estafanous et al, 1973) in patients with normal blood gases, adequately sedated, synchronized with the ventilator, not shivering, and with no neurological complications. Immediate control of hypertensive episodes may prevent acute left ventricular failure, cerebrovascular accidents and excessive bleeding.…”

“…(level of the S-T segment) are decreased, and arrhythmias become less frequent or disappear completely ( fig. 2) (Estafanous and Viljoen, 1974). Myocardial revascularization is a rational therapeutic approach to the acutely hypoxic myocardium.…”

“…As atherosclerosis can affect arteries beyond the point at which they can be grafted, there is a theoretical argument to be made for a drug which dilates the smaller vessels. Nitroglycerin increases blood flow in the coronary arteries beyond the points of narrowing (Fam and McGregor, 1964;Fam et al, 1966) and it also dilates collaterals; the myocardial oxygen tension in the areas of distribution of the occluded vessels will thus be increased. Many components of the response to nitroglycerin, namely decrease in cardiac size (Bousvaros, Campbell, and McGregor, 1966) decrease in venous return (Gorlin et al, 1959) decrease in pulmonary and systemic arterial pressure and rate of ventricular contraction (Darby and Aldinger, 1960) will decrease the myocardial oxygen consumption (Robin et al, 1967).…”

“…On the day following surgery the patient's ventilatory status was assessed. The following criteria were fulfilled before the endotracheal tube was removed (Estafanous and Viljoen, 1973).…”