Althesin in high risk patients with heart disease in orthopedic surgery

Althesin was used in 65 patients with heart diseases undergoing orthopedic surgery, alone or in association with neuroleptanalgesic drugs. Patients were classified according to four types of heart diseases: atrial fibrillation in older patients (41.53%), disorders of cardiac rhythm (23.07%), valvular diseases (9.23%), ischemic heart disease (26.15%) and according to the degree of risk (ASA 3 and 4). All patients were carefully studied before the operation, and adequately treated with cardiac drugs in order to reduce heart rate, to reduce blood pressure and to reduce heart failure, whenever necessary. Anesthesia was induced with Althesin in all patients, and maintained with Althesin/N2O/O2 in 24.61% of the cases, and Althesin/N2O/O2/NLA in 75.39% of the cases. No significant changes in heart rate or in blood pressure were observed either during surgery or in the first 24 hours after the operation. There were five deaths in the days after the operation, one of which was due to surgery. One patient was discharged while still in a coma. All the other patients were discharged from the hospital within approximately four weeks from the day of the operation in good general condition. It was concluded that Althesin is a very reliable anesthetic agent for patients with heart diseases.