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Changes in left ventricular diameter during intravenous induction of anesthesia
G Dahlgren1, G Settergren, A Ribeiro
1Department of Cardiothoracic Anaesthetics, Karolinska Hospital, Stockholm, Sweden.
Journal of Cardiothoracic and Vascular Anesthesia
|August 1, 1993
Summary
Anesthetic induction for coronary artery bypass grafting significantly reduced left ventricular preload and afterload. Echocardiography revealed a 34% decrease in end-diastolic volume during anesthesia induction.
Area of Science:
- Cardiology
- Anesthesiology
- Cardiovascular Surgery
Background:
- Anesthetic induction can alter cardiac function.
- Understanding hemodynamic changes during induction is crucial for patient safety, especially in cardiac surgery patients.
Purpose of the Study:
- To assess the impact of anesthetic induction on left ventricular dimensions and hemodynamics.
- To quantify changes in preload and afterload during induction for coronary artery bypass grafting (CABG).
Main Methods:
- Transthoracic two-dimensional echocardiography was used to measure left ventricular end-systolic and end-diastolic diameters.
- Hemodynamic parameters including preload (end-diastolic diameter) and afterload (systolic diameter and pressure) were monitored.
- Patients received midazolam, fentanyl, pancuronium, and topical lidocaine before intubation.
Main Results:
- A gradual decrease in diastolic diameter (preload) and systolic diameter and pressure (afterload) was observed during anesthetic induction.
- End-diastolic diameter decreased from 4.6 cm to 3.9 cm, indicating an approximate 34% reduction in preload (end-diastolic volume).
Conclusions:
- Anesthetic induction for CABG leads to significant reductions in left ventricular preload and afterload.
- These findings align with previous studies using radionuclide cardiography and thermodilution to assess ventricular volumes during anesthesia induction.