MILDRONATE POTENTIAL FOR CARDIAC ARRHYTHMIA PREVENTION IN PERIOPERATIVE PERIODcardiac arrhythmias, ischemia, metabolic disturbances, cytoprotectors, antioxidants, operation-related stress, general anesthesia, Mildronate

Abstract

Aim. To assess the effectiveness of Mildronate in the prevention of arrhythmias during the perioperative period of open cholecystectomy under intravenous multicomponent anesthesia.Material and methods. In total, 69 patients were divided into 3 groups: with concomitant coronary heart disease (CHD), with essential arterial hypertension (EAH), or without concomitant cardiovascular disease (CVD). Each group was divided into a control subgroup (total n=36) receiving conventional treatment and a main subgroup (total n=33) additionally receiving Mildronate (500 mg twice a day intravenously: 24 hour before the operation, during premedication, during early postanesthetic period, and for 2 days after the operation). Arrhythmic episodes were registered at Holter ECG monitoring for 4 days: 24 hours before the operation; 24 hours of the operation; and 48 hours after the operation. The monitoring period was divided into 6 intervals: 1 — preoperation; 2–6 hours before the operation; 3 — anesthesia start; 4 — anesthesia maintenance; 5 — anesthesia finish; and 6 — second day after the operation.Results. Cardiac arrhythmias were registered not only among patients with EAH and CHD, but also with patients without concomitant CVD.Conclusion. Mildronate therapy reduced the number of arrhythmic episodes at different stages of perioperative period, particularly in the anesthesia start, finish, and maintenance periods among patients with CHD and EAH, as well as among CVD-free patients.