Hoeft A, Sonntag H, Stephan H, Kettler D: The influence of anaesthesia on myocardial oxygen utilization efficiency in patients undergoing coronary bypass surgery. Anesth Analg 1994, 78:857-866. The authors of this retrospective study report no difference in effect between the various anaesthetic techniques, especially as concerns myocardial oxygen consumption.
Ramsay JG, DeLima LGR, Wynands JE, O'Connor JP, Ralley FE, Robbins R: Pure opioid versus opioid-volatile anaesthesia for coronary artery bypass graft surgery: a prospective, randomized, double-blind study. Anesth Analg 1994, 78:867-875. This prospective study showed similar incidences of pre-CPB ischaemia and perioperatrve myocardial infarctions when anaesthesia was provided with opiates alone or combined with volatile agents.
Parsons RS, Jones RM, Wrigley SR, MacLeod KGA, Platt MW: Comparison of desflurane and fentanyl-based anaesthetic techniques for coronary artery bypass surgery. Br J Anaesth 1994, 72:430-438. The authors compared an anaesthetic based on desflurane with a technique using high-dose fentanyl. They showed that use of the volatile agent provided stable haemodynamics.
Bell J, Sartam J, Wilkinson GAL, Sherry KM: Propofol and fentanyl anaesthesia for patients with low cardiac output state undergoing cardiac surgery: comparison with high-dose fentanyl anaesthesia. Br J Anaesth 1994, 73:162-166. These authors failed to find a difference in haemodynamics when propofol and low-dose fentanyl were infused, compared with the use of high-dose fentanyl.
Higgins TL, Yared JP, Estafanous FG, Coyle JP, Ko HK, Goodale DB: Propofol versus mldazolam for intensive care unit sedation after coronary artery bypass grafting. Crit Care Med 1994, 22:1415-1423. A comparison of the efficacy of propofol with that of midazolam for ICU sedation; no difference was found in time to extubation or in ICU stay.
Ralley FE: Combined technique for cardiac anaesthesia. Car Anaesth 1994, 41:1140-1143.
Stenseth R, Bjella L, Berg EM, Christensen O, Levang OW, Gisvold S. Thoracic epidural analgesia in aortocoronary bypass surgery haemodynamic effects. Acta Anaesthesiol Scand 1994, 38:826-8: The authors demonstrated easier control of perioperative hypertension a tachycardia when general anaesthesia was combined with thoracic epidu anaesthesia.
Stenseth R, Bjella L, Berg EM, Christensen O, Levang OW, Gisvold SI. Thoracic epidural analgesia in aortocoronary bypass surgery I effects on the endocrine metabolic response. Acta Anaesthesiol Scand 1994, 38:834-839.
Kirnö K, Friberg P, Grzegorczyk A, Milocco I, Ricksten SE, Lundin S: Thoracic epidural anaesthesia during coronary artery bypass surgery: effects on cardiac sympathetic activity, myocardial blood flow and metabolism, and central haemodynamlcs. Anesth Analg 1994, 79:1075-1081. In this study of patients with thoracic epidural anaesthesia combined with general anaesthesia, no metabolic or electrocardiographic evidence of myocardial ischaemia was found.
Kowalewski RJ, MacAdams CL, Eagle CJ, Archer DP, Bharadwaj B: Anaesthesia for coronary artery bypass surgery supplemented with subarachnoid bupivacaine and morphine: a report of 18 cases. Can J Anaesth 1994, 41:1189-1195. The authors demonstrate that a general anaesthetic combined with intrathecal bupivacaine/morphine can be an effective technique for myocardial revascularization surgery.
Karzai W, Gunnicker M, Vorgrimler-Karzai UM, Freund U, Zerkowski HR: The effects of β-adrenoreceptor blockade on oxygen consumption during cardiopulmonary bypass. Anesth Analg 1994, 79:19-22. This study shows that chronic β-blockade is associated with lower oxygen consumption.
Cork RC, Kramer TH, Dreischmeier B, Behr S, DiNardo JA: The effect of esmolol given during cardiopulmonary bypass. Anesth Analg 1995, 80:28-40.
Hannes W, Seitelberger R, Christoph M, Keilich M, Kulinna C, Holubarsch C, Fasol R: Effect of peri-operative diltiazem on myocardial Ischaemia and function in patients receiving mammary artery grafts. Eur Heart J 1995, 16:87-93. These authors show that intravenous diltiazem is effective in the prevention of perioperative myocardial ischaemia in patients having revascularization with use of an internal mammary artery graft.
Christenson JT, Schmuziger M, Maurice J, Simonet F, Velebit V: Gastrointestinal complications after coronary artery bypass grafting. J Thorac Cardiovasc Surg 1994, 108:899-906.
Ohri SK, Becket J, Brannan J, Keogh BE, Taylor KM: Effects of cardiopulmonary bypass on gut blood flow, oxygen utilization, and intramucosal pH. Ann Thorac Surg 1994, 57:1193-1199.
Uusaro A, Ruokonen E, Takala J: Gastric mucosal pH does not reflect changes in splanchnic blood flow after cardiac surgery. Br J Anaesth 1995, 74:149-154. These authors conclude that gastric mucosal pH does not reflect splanchnic blood flow and oxygen delivery after cardiac surgery. This suggests either heterogeneous or inadequate distribution of flow.
Parviainen I, Ruokonen E, Takala J: Dobutamine-induced dissociation between changes in splanchnic blood flow and gastric intramucosal pH after cardiac surgery. Br J Anaesth 1995, 74:277-282. These authors conclude that dobutamine leads to a dissociation between splanchnic oxygen delivery and oxygenation of the gastric mucosa, suggesting inappropriate distribution of blood flow in this vascular bed.
