Gotou K, Kimura F, Kimura N, Hashimoto Y, Wakayama S
Department of Anesthesiology, Jieitai Misawa Hospital.
Masui. 1997 Dec;46(12):1609-14.
We describe our experience with three patients in chronic renal failure who underwent coronary artery bypass surgery without cardiopulmonary bypass. Anesthesia was maintained with fentanyl and midazolam. Nitroglycerin and prostaglandin E1 were administered during the surgical procedure. When the coronary artery was clamped for the anastomosis of the graft, cardiac output and arterial pressure decreased in all cases. The patients were treated with ephedrine and dobutamine, which restored the hemodynamics. The important points for the anesthetic management for this operation are follows: the adequate administration of the coronary vasodilator, and attention to the change of hemodynamics on clamping the coronary artery.
我们描述了3例慢性肾衰竭患者在非体外循环下行冠状动脉搭桥手术的经验。麻醉维持采用芬太尼和咪达唑仑。手术过程中给予硝酸甘油和前列腺素E1。当为吻合移植物而夹闭冠状动脉时，所有病例的心输出量和动脉压均下降。患者接受麻黄碱和多巴酚丁胺治疗，血流动力学得以恢复。该手术麻醉管理的要点如下：充分给予冠状动脉血管扩张剂，并注意夹闭冠状动脉时血流动力学的变化。
