Tarhan S, White R D, Raimundo H S
Ann Thorac Surg. 1979 Apr;27(4):376-89. doi: 10.1016/s0003-4975(10)63322-x.
Between 1964 and 1978, aortocoronary bypass graft procedures were performed in more than 300,000 patients, and the number seems to increase every year. Nevertheless, the procedure itself can result in perioperative myocardial infarction leading to death. Greater understanding of and constant attention to the myocardial oxygen (O2) supply and demand may reduce the incidence of perioperative myocardial infarction. Some of the factors influencing supply and demand can be controlled pharmacologically. Drugs such as nitroglycerin, nitroprusside, and propranolol can reduce the myocardial O2 demand. Unfortunately, there are few data to elucidate the relationship between myocardial O2 demand and supply as influenced by anesthetic drugs, especially in patients with myocardial ischemia. However, enthusiasm for aortocoronary bypass graft operations has given enormous impetus to laboratory and clinical studies of this subject. Recent developments in anesthetic management afford better means for protection of the ischemic myocardium during and after operation.
1964年至1978年间，超过30万患者接受了主动脉冠状动脉搭桥移植手术，而且这一数字似乎每年都在增加。然而，该手术本身可能导致围手术期心肌梗死并致死。对心肌氧供需的深入理解和持续关注可能会降低围手术期心肌梗死的发生率。一些影响供需的因素可以通过药物进行控制。硝酸甘油、硝普钠和普萘洛尔等药物可以降低心肌氧需求。遗憾的是，关于麻醉药物对心肌氧供需关系的影响，尤其是在心肌缺血患者中的相关数据很少。然而，对主动脉冠状动脉搭桥手术的热情极大地推动了该主题的实验室和临床研究。麻醉管理方面的最新进展为手术期间和术后保护缺血心肌提供了更好的方法。
