Kar Sandeep Kumar, Dasgupta Chaitali Sen, Goswami Anupam
Department of Cardiac Anaesthesia, Institute of Post Graduate Medical Education and Research, Kolkata, India.
Ann Card Anaesth. 2011 Sep-Dec;14(3):176-82. doi: 10.4103/0971-9784.83986.
The study was carried out to evaluate the effect of prophylactic single-dose intravenous amiodarone in patients undergoing valve replacement surgery. Maintenance of sinus rhythm is better than maintenance of fixed ventricular rate in atrial fibrillation (AF) especially in the presence of irritable left or right atrium because of enlargement. Fifty-six patients with valvular heart disease with or without AF were randomly divided into two groups. Group I or the amiodarone group (n=28) received amiodarone (3 mg/kg in 100 ml normal saline) and group II or the control group received same volume of normal saline. The standardized protocol for cardiopulmonary bypass was maintained for all the patients. AF occurred in 7.14% patients in group I, and in group II, 28.57% (P=0.035); ventricular tachycardia/fibrillation was observed in 21.43% patients in group I and 46.43% patients in group II (P=0.089) after release of aortic clamp. Most of the patients in group I (92.86%) maintained sinus rhythm without cardioversion or defibrillation after release of aortic cross clamp (P=0.002). Defibrillation or cardio version was needed in 7.14% patients in group I and 28.57% patients in group II (P=0.078). A single prophylactic intraoperative dose of intravenous amiodarone decreased post bypass arrhythmia in this study in comparison to the control group. Single dose of intraoperative amiodarone may be used to decrease postoperative arrhythmia in open heart surgery.
本研究旨在评估预防性单剂量静脉注射胺碘酮对接受瓣膜置换手术患者的影响。在心房颤动（AF）中，维持窦性心律优于维持固定心室率，尤其是在存在因心房扩大导致的易激惹左心房或右心房时。56例患有或不患有AF的瓣膜性心脏病患者被随机分为两组。第一组或胺碘酮组（n = 28）接受胺碘酮（3 mg/kg溶于100 ml生理盐水中），第二组或对照组接受相同体积的生理盐水。所有患者均维持标准化的体外循环方案。第一组7.14%的患者发生AF，第二组为28.57%（P = 0.035）；主动脉夹松开后，第一组21.43%的患者观察到室性心动过速/心室颤动，第二组为46.43%（P = 0.089）。第一组大多数患者（92.86%）在主动脉交叉夹松开后无需心脏复律或除颤即可维持窦性心律（P = 0.002）。第一组7.14%的患者和第二组28.57%的患者需要除颤或心脏复律（P = 0.078）。与对照组相比，本研究中术中预防性单剂量静脉注射胺碘酮可降低体外循环后心律失常的发生率。术中单剂量胺碘酮可用于降低心脏直视手术术后心律失常的发生率。
