Baraka A, Usta N, Baroody M, Haroun S, Dagher I, Haddad R
Anesth Analg. 1987 Jun;66(6):560-4.
In 12 of 22 patients with coronary artery disease undergoing elective coronary artery bypass graft (CABG), verapamil (0.075 mg/kg body weight) pretreatment was given on initiation of cardiopulmonary bypass (CPB) before aortic cross-clamping (ACC), whereas no verapamil was used in 10 control patients. The volume of cardioplegia solution required to achieve and maintain cardiac asystole during ACC while on CPB was not significantly different in the two groups. After the release of ACC, the energy of direct current countershock required for defibrillation, the incidence of heart block, and the need for pacemaker were not significantly different. However, defibrillation was more readily achieved by a single countershock in the verapamil group than in the control group. Also, the incidence of ST segment changes after defibrillation was significantly lower in the verapamil group, suggesting that verapamil pretreatment before ACC may potentiate the myocardial preservation achieved by the cardioplegia, and hence may decrease the incidence of ischemic changes during the critical reperfusion period.
在22例接受择期冠状动脉旁路移植术（CABG）的冠心病患者中，12例在体外循环（CPB）开始且主动脉阻断（ACC）前给予维拉帕米（0.075 mg/kg体重）预处理，而10例对照患者未使用维拉帕米。两组在CPB期间ACC时实现并维持心脏停搏所需的心脏停搏液体积无显著差异。ACC解除后，除颤所需的直流电复律能量、心脏传导阻滞的发生率以及起搏器的需求无显著差异。然而，维拉帕米组单次复律比对照组更容易实现除颤。此外，维拉帕米组除颤后ST段改变的发生率显著更低，提示ACC前维拉帕米预处理可能增强心脏停搏液对心肌的保护作用，从而可能降低关键再灌注期缺血改变的发生率。
