Mephentermine and intravenous fluids for the prevention of hypotension associated with spinal anesthesia.
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Biomedical subjects
Publications and source records attributed to R F Cucchiara.
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A patient with severe bullous emphysema in whom one bulla occupied an entire hemithorax and shifted the mediastinum to the opposite side was anesthetized for bullectomy in a lateral thoracotomy position using an awake intubation with a Bryce-Smith double-lumen endotracheal tube under spontaneous ventilation on room air. The maintenance anesthetic was halothane and oxygen, with pancuronium bromide for relaxation and ventilation of the good lung only. This technique avoids many of the potential problems presented by this type of patient.
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In 12 patients undergoing saphenous vein coronary artery bypass operations, cardiovascular hemodynamics were studied in the awake state (control) and during anesthesia with isoflurane (inspired concentration, 1.24%, 7 patients) or with halothane (inspired concentration, 0.77%, 5 patients). Isoflurane anesthesia was accompanied by decreases of 19% in the cardiac index (Q), 19% in mean arterial pressure (AP), and 16% in heart rate (HR). Only the change in AP was statistically significant. Halothane anesthesia was accompanied by decreases in Q (28%), AP (22%), and HR (10%). The changes in Q and AP were significant. HR did not change significantly following the induction of anesthesia with either agent. The decrease in AP was similar with both agents, and, in this regard, neither agent was clearly superior for patients with occlusive coronary artery disease.