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[Preventive digitalis therapy in open thoracotomy]

A Kaiser1, G Zünd, W Weder

  • 1Departement Chirurgie, Universitätsspital Zürich.

Helvetica Chirurgica Acta
|December 1, 1994
PubMed
Summary

Prophylactic digitalization after open lung surgery does not prevent cardiac arrhythmias. This study found no benefit, suggesting individualized treatment for arrhythmias is more appropriate than routine digoxin use.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pharmacology

Background:

  • Prophylactic digitalization is a common recommendation post-open lung surgery to prevent cardiac arrhythmias.
  • The documented benefits of this potentially harmful medication are limited, necessitating further investigation.

Purpose of the Study:

  • To evaluate the efficacy of prophylactic digitalization in preventing postoperative cardiac arrhythmias after open lung surgery.
  • To determine if routine digoxin administration is indicated in the postoperative period for patients undergoing thoracic procedures.

Main Methods:

  • A prospective randomized trial was conducted involving patients undergoing elective open lung surgery.
  • Patients were divided into two groups: one receiving postoperative digoxin, the other serving as a control.
  • Randomization considered surgical extent and patient age, with continuous monitoring and ECG registration.

Main Results:

  • Cardiac arrhythmias were frequent postoperatively, peaking between days 3 and 5.
  • Any arrhythmias occurred in 63% of the digoxin group versus 40% of the control group.
  • Symptomatic arrhythmias requiring treatment were significantly higher in the prophylactic digitalization group (33.3%) compared to the control group (11.4%).

Conclusions:

  • General prophylactic digitalization is not indicated after open lung surgery.
  • Individualized treatment of cardiac arrhythmias is recommended over routine prophylactic digoxin use.

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