Efficacy of strategy of optimizing anesthetic management in preventing occurrence of cardiac arrest during thoracic surgery
10.3760∕cma.j.issn.0254-1416.2016.11.014
- VernacularTitle:优化麻醉管理策略预防普胸手术中病人心跳骤停发生的效果
- Author:
Dehua WU
;
Jingya MA
;
Hongwei ZHU
;
Jingxiang WU
;
Meiying XU
- Keywords:
Anesthesia,general;
Thoracic surgical procedures;
Heart arrest;
Intraoperative complications
- From:
Chinese Journal of Anesthesiology
2016;36(11):1333-1336
- CountryChina
- Language:Chinese
-
Abstract:
The strategy of optimizing anesthetic management was carried out in all the patients un?dergoing thoracic surgery in our hospital from January 1, 2012: the patients were monitored using routine electrocardiogram combined with invasive arterial blood pressure monitoring, double?lumen central venous catheter pathway was established, and when severe bradycardia ( heart rate<40 beats∕min) occurred, inter?vention was carried out immediately, and chest compression was performed timely. Medical records of 15 212 patients from July 1, 2006 to December 31, 2011 ( before optimizing anesthetic management) as well as medical records of 17 078 patients from January 1, 2012 to January 15, 2015 ( after optimizing an?esthetic management) were reviewed. The data including baseline patient characteristics as well as the time period and causes of cardiac arrest, rescue time, rescue measures, successful resuscitation and prognosis in the patients developing intraoperative cardiac arrest were collected. Before optimizing anesthetic manage?ment, 28 patients developed cardiac arrest, the incidence was 0?184%, successful resuscitation was found in 25 cases, the success rate of resuscitation was 89%, and there were 3 cases in whom resuscitation failed due to massive hemorrhage?induced cardiac arrest. After optimizing anesthetic management, 17 patients de?veloped cardiac arrest, the incidence was 0?109%, massive hemorrhage?induced cardiac arrest was not found in patients, and the success rate of resuscitation was 100%. Prognosis was good after surgery in suc?cessfully resuscitated patients. Compared with the values before optimizing anesthetic management, the in?cidence of cardiac arrest was significantly decreased (P=0?05), and no significant change was found in the other parameters after optimizing anesthetic management ( P>0?05) , and the incidence of cardiac arrest was decreased by 45% after optimizing anesthetic management. In conclusion, the strategy of optimizing anesthetic management is helpful in decreasing the occurrence of cardiac arrest during thoracic surgery.
