Abstract | OBJECTIVE: To assess the relative efficacy of a pacing esophageal stethoscope and intermittent boluses (40 mg) of gallamine in correcting sinus bradycardia (SB) during coronary artery surgery. DESIGN: The study was prospective, randomized, and controlled. SETTING: A community hospital. PARTICIPANTS: Fifty patients scheduled for elective coronary artery surgery. INTERVENTIONS: The patients were randomly allocated to receive treatment for an SB (less than 60 BPM) with either transesophageal atrial pacing (TAP) or gallamine. MEASUREMENTS AND MAIN RESULTS: Heart rate, blood pressure, and systemic hemodynamics were measured. The electrocardiogram was monitored for rate, rhythm, and conduction abnormalities. Twenty-four of the 25 TAP patients could be paced at a rate of 70 BPM after SB. Cardiac index increased from 1.90 to 2.56 L/min/m2. In the gallamine group, heart rate was increased from 50 to 66 BPM, but cardiac index only increased to 2.2 L/min/m2, and 2 patients developed nodal rhythms. Eight of these patients had peak heart rates over 80 BPM, and two were over 90 BPM. CONCLUSIONS: The ability to reliably and precisely control heart rate was superior with TAP compared with intermittent bolus dosing with gallamine.
|
Authors | R C Tomichek, J A Shields, R E Zimmerman |
Journal | Journal of cardiothoracic and vascular anesthesia
(J Cardiothorac Vasc Anesth)
Vol. 9
Issue 3
Pg. 259-63
(Jun 1995)
ISSN: 1053-0770 [Print] United States |
PMID | 7669957
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
|
Chemical References |
|
Topics |
- Arrhythmia, Sinus
(drug therapy, therapy)
- Auscultation
(instrumentation)
- Blood Pressure
(drug effects)
- Bradycardia
(drug therapy, therapy)
- Cardiac Output
(drug effects)
- Cardiac Pacing, Artificial
(methods)
- Coronary Artery Bypass
(adverse effects)
- Elective Surgical Procedures
- Electrocardiography
(drug effects)
- Esophagus
- Female
- Gallamine Triethiodide
(administration & dosage, therapeutic use)
- Heart Atria
- Heart Rate
(drug effects)
- Humans
- Injections, Intravenous
- Intraoperative Complications
(therapy)
- Male
- Middle Aged
- Prospective Studies
|