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ST segment changes following retinal surgery

Y Gozal1, B Drenger, J E Robertson

  • 1Department of Anesthesiology, Oregon Health Sciences University, Portland, USA.

Journal of Clinical Anesthesia
|July 17, 1998
PubMed
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Retinal surgery can lead to significant perioperative cardiac events, with over 26% of patients experiencing silent myocardial ischemia. Patients with multiple cardiac risk factors showed a higher incidence of these events.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Anesthesiology

Background:

  • Perioperative cardiac morbidity is a concern in surgical patients.
  • Retinal surgery, often performed under local anesthesia, requires careful cardiac monitoring.

Purpose of the Study:

  • To investigate the incidence and characteristics of perioperative cardiac morbidity in adult patients undergoing retinal surgery.
  • To assess the relationship between cardiac risk factors and ischemic events during the perioperative period.

Main Methods:

  • A prospective study was conducted at a university hospital.
  • 56 adult patients undergoing elective retinal surgery with local anesthesia were monitored using Holter recorders for 24 hours.
  • Blood samples for creatine phosphokinase (CPK) and CPK-MB were analyzed preoperatively and postoperatively.

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Main Results:

  • A high incidence of perioperative myocardial ischemia was observed (26.7%), with most episodes being silent.
  • Patients with two or more cardiac risk factors experienced significantly more ischemic episodes (p < 0.005).
  • Ischemia primarily occurred postoperatively, with no intraoperative events or acute myocardial infarctions detected.

Conclusions:

  • Retinal surgery under local anesthesia is associated with a substantial rate of postoperative myocardial ischemia.
  • Currently, no negative clinical outcomes were directly correlated with these ischemic events.
  • Further evaluation is needed to determine the clinical significance of these findings.