During neurolept anarsrheria, calcium rhloride (15 ing/kg) was admiiiistrred intravenously to two diflei.ciit groups of patients undergoing vascular surgery on the abdominal aorta. The patients in group I all sufyered from cardiac disease and we1.e treated with digoxin, while the patients in group I1 had no cardiac symptoms. Cardiovascular nicasureiricnts were made during steady-state anaesthesia. In group I, CaC12 increased cardiac index (GI) significantly while systemic vascular resistance index (SVRI) remained unchanged. Mean arterial pressurc (MAP) increased. In group 11, both MAP and SVRI increased while CI remained unchanged. N o significant changes in hcart rate were ohserved and no arrhythmias occurred. It is concluded that CaC12 administered intravenously is an eft'ective means of improving cardiac fiinction whcn i t is depressed by anaesthesia, underlying cardiac disease, or both.
The haemodynamic changes occurring during induction of neurolept anaesthesia and intubation in patients with reduced cardiac reserve were compared with the haemodynamic changes observed prior to operation during the stress of moderate physical exercise in the same patients. Anaesthesia consisted of droperidolum NFN (Dehydrobenzperidol"), fentanyli citras NFN (Haldidm) and nitrous oxide-oxygen with suxamethonium for intubation. The haemodynamic parameters measured were mean arterial blood pressure, central venous pressure, pulmonary artery mean pressure, pulmonary capillary wedge pressure and cardiac output. Blood volume was also measured, as were arterial blood-gas tensions and pH. The haemodynamic changes observed during induction with intubation were significantly smaller than those observed preoperatively during exercise.
The cardiovascular reaction to primarily niaior vascular surgery was examined in 39 patients without cardiac disease and in 11 patients with cardiac disease.
In the immediate postoperative period (24 h), patients without cardiac disease showed significant increases in heart rate and cardiac index and a decreased blood volume. The central pressures were increased during the first postoperative hour. Systemic blood pressure and vascular resistance remained unchanged, or decreased slightly. Postoperative haemodynamics in patients with cardiac disease followed the same trends as in normal patients; there were, however, no significant changes in cardiac index or central pressures, and in general the cardiovascular reaction to operation was less conspicuous than in the group of normal patients. The pre‐operative haemodynamic differences between the two groups were diminished in the immediate postoperative period because therapy could be guided by measuring central pressures.
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