The perioperative management of patients with recent myocardial infarction undergoing non-cardiac surgery
- VernacularTitle:急性心肌梗死康复期病人非心脏手术的麻醉处理
- Author:
Xiaofeng ZHUANG
;
Zhanggang XUE
;
Hao JIANG
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Anesthesia, epidural;
Anesthesia, general;
Non-cardiac surgery
- From:
Chinese Journal of Anesthesiology
1994;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective The purpose of this study was to evaluate the perioperative management of patients with recent myocardial infarction (MI) undergoing non-cardiac surgery.Methods Twelve patients underwent general or thoracic surgery on the 72th to 175th day after acute MI. Their mean age was (67?4 ) years old. All patients received epidural block or epidural block combined with general anesthesia. Epidural catheter was left in place for postoperative analgesia.Results All patients underwent operation smoothly. During operation ECG monitoring showed no ischemic ST-T changes. Postoperative pain relif was satisfactory. No acute heart failure or myocardial reinfarction occurred during their stay in hospital.Conclusions In patients who had recent MI the time interval between the first MI and surgery should not be the only factor in the risk assessment. Other factors such as urgency of surgery, the severity of coronary artery disease, exercise tolerance and complexity of surgery should also be considered. Adequate preoperative evaluation and preparation and maintenance of cardiac function during perioperative period are crucial to the safety of surgery. Epidural block combined with general anesthesia is the anesthesia of choice for patient with recent MI undergoing non-cardiac surgery.
