Une nouvelle technique anesthésique pour la chirurgie cardiaque vigile

Hemmerling, Thomas M.; Noiseux, Nicolas; Basile, Fadi; Noël, Marie-Frédérique; Prieto, Ignatio

doi:10.1007/bf03021610

Cited by 17 publications

(12 citation statements)

References 13 publications

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“…HTEA is largely employed to awake patients undergoing cardio-thoracic surgery and could provide an opportunity for patients with primary and secondary pulmonary impairments [11][12][13][14] . Indeed, the scientific literature and the clinical experience have already demonstrated the high risk of respiratory complications after general anaesthesia in patients with obesity, chronic obstructive disease, pulmonary fibrosis and so on [12][13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

High Thoracic Epidural Anaesthesia for Endocardial Ablation of Atrial Fibrillation: A Single Centre Experience

2017

ARC Journal of Anesthesiology

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Section: Discussionmentioning

confidence: 99%

High Thoracic Epidural Anaesthesia for Endocardial Ablation of Atrial Fibrillation: A Single Centre Experience

2017

ARC Journal of Anesthesiology

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“…[88,91] Further studies are necessary to determine its role and utility in cardiac surgery. [84] Opening of pleura is a major concern during awake cardiac surgery and the surgeons should take care to avoid this to prevent pneumothorax and internal mammary artery should be harvested extrapleural without opening the pleura. Temperature management is particularly challenging in OPCAB as the absence of CPB removes the possibility to warm up the patient with a heat exchanger.…”

Section: Premedication and Monitoringmentioning

confidence: 99%

“…Further studies are required to verify the effectiveness of this technique and to determine the optimal dose of morphine, which provides adequate analgesia with minimal risk of respiratory depression that appears to be the most important side effect during the postoperative period. Awake OPCAB is a promising modality of minimally invasive cardiac anesthesia [83] which uses a combined femoral block/TEA [84] or spinal anesthesia/TEA [85] or TEA alone, associating local anesthetic infiltration if required for the vessel graft harvesting [86][87][88] [ Figure 3]. [83] Awake cardiac surgery might have some benefits, such as short ICU stay.…”

Section: Premedication and Monitoringmentioning

confidence: 99%

Anesthesia for off-pump coronary artery bypass surgery

et al. 2013

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The evolution of techniques and knowledge of beating heart surgery has led anesthesia toward the development of new procedures and innovations to promote patient safety and ensure high standards of care. Off-pump coronary artery bypass (OPCAB) surgery has shown to have some advantages compared to on-pump cardiac surgery, particularly the reduction of postoperative complications including systemic inflammation, myocardial injury, and cerebral injury. Minimally invasive surgery for single vessel OPCAB through a limited thoracotomy incision can offer the advantage of further reduction of complications. The anesthesiologist has to deal with different issues, including hemodynamic instability and myocardial ischemia during aorto-coronary bypass grafting. The anesthesiologist and surgeon should collaborate and plan the best perioperative strategy to provide optimal care and ensure a rapid and complete recovery. The use of high thoracic epidural analgesia and fast-track anesthesia offers particular benefits in beating heart surgery. The excellent analgesia, the ability to reduce myocardial oxygen consumption, and the good hemodynamic stability make high thoracic epidural analgesia an interesting technique. New scenarios are entering in cardiac anesthesia: ultra-fast-track anesthesia with extubation in the operating room and awake surgery tend to be less invasive, but can only be performed on selected patients.

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“…Erweiterungen der regionalanästhesi-ologischen Techniken wie die N.-femoralis-Blockade [26,53] oder auch eine lumbale Spinalanästhesie [44] ermöglichen die zusätzliche Entnahme von Beinvenen und damit auch komplexere Koronarrevaskularisationen mit bis zu 4 Anschlüssen [53]. Darüber hinaus existiert ein Fallbericht über die koronare Bypassoperation in Epiduralanästhesie mit anschließender Karotisdesobliteration, die mithilfe eines Zervikalblocks durchgeführt wurde [22].…”

Section: Anästhesiologische Technikunclassified

“…k.A. Lucchetti et al [44] MS (n=1) LIMA+ACVB RIVA+RCX Hemmerling et al [26] MS (n=2) LIMA+ACVB RIVA+RCX Gerosa et al [22] MS (n=1) LIMA RIVA Noiseux et al [53] MS (n=15)…”

Section: Tab 3 Anästhetikalösungen Und Dosierungen Zur Hohen Thorakamentioning

confidence: 99%

Koronare Bypasschirurgie am wachen Patienten

Byhahn

Meininger²,

Kessler³

2008

Anaesthesist

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Patients undergoing coronary artery bypass grafting increasingly show severe co-morbidities, which can negatively affect the outcome. Recent developments in cardiac surgery have therefore focused on minimizing the invasiveness of the procedure by revascularization on the beating heart without cardiopulmonary bypass, and by reducing surgical trauma using smaller surgical incisions. Progress in minimally invasive cardiac surgery has led to minimally invasive anesthesia, i.e. using high thoracic epidural anesthesia as the sole technique in the conscious patient (awake coronary artery bypass grafting, ACAB). Published data on ACAB procedures in smaller cohorts have demonstrated that the procedure is safe. Significant complications occurred in 7.1% of patients. A particular cause of concern during ACAB surgery is the development of spinal epidural hematoma the risk of which has been estimated to be as high as 1:1,000. A thorough risk-benefit analysis has therefore to be made. Currently, ACAB surgery remains limited to few specialized centers and highly selected patients.

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Une nouvelle technique anesthésique pour la chirurgie cardiaque vigile

Cited by 17 publications

References 13 publications

High Thoracic Epidural Anaesthesia for Endocardial Ablation of Atrial Fibrillation: A Single Centre Experience

High Thoracic Epidural Anaesthesia for Endocardial Ablation of Atrial Fibrillation: A Single Centre Experience

Anesthesia for off-pump coronary artery bypass surgery

Koronare Bypasschirurgie am wachen Patienten

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