01:54,4,Jan,2006 | (900/0/0) | Original

mitral stenosis anaesthesia

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mitral stenosis anaesthesia

Abstract: Objective To study the continuous infusion of dopamine for patients with severe mitral stenosis induction of anesthesia to maintain stable security of circulatory function. Methods of severe mitral valve replacement in patients with mitral stenosis in 20 cases. Randomly divided into 2 groups. Ⅰ group simply using midazolam, fentanyl and droperidol rocuronium induced; Ⅱ group before the induction of intravenous dopamine infusion pump input 3μgkg ^-1min ^ -1, then midazolam, fentanyl and droperidol rocuronium induction. Before induction, after drug administration, immediately after intubation, 2,5,10 min after intubation, respectively, monitoring of blood pressure, heart rate, blood oxygen saturation. Results of dopamine in patients blood pressure was not obvious after induction of anesthesia, heart rate and blood pressure after tracheal intubation, heart rate changed little. The control group after induction of anesthesia, blood pressure, heart rate decreased and slowed down; and tracheal intubation, blood pressure, heart rate increase and speed up significantly. Conclusion before induction of anesthesia dose dopamine infusion to maintain hemodynamic help to maintain stability. Number of pages: 3 pages :260-261 range, F0004 page Keywords: severe mitral stenosis induction of dopamine subject classification: R614 [medicine, HEALTH "outside SCIENCES" surgical operation> Anesthesiology] Related Articles: Topics Related references (5) citations (1)
1, pathophysiological characteristics
(1) lack of left ventricular filling, limiting adequate cardiac output.
(2) both left atrial pressure and volume overload.
(3) pulmonary hypertension.
(4) due to pressure overload induced right ventricular dysfunction failure.
(5), accompanied with atrial fibrillation, some of thrombosis.
2, the anesthetic management principles
(1) to prevent tachycardia, tachycardia, diastolic time is short, but also reduce left ventricular filling, cardiac output to decline further.
(2) to prevent bradycardia, cardiac output per
minute to be a certain number of heart stroke volume compensate for the deficiency, such as loss of compensatory bradycardia, blood pressure will be in serious decline.
(3) increased pressure on the right and left low cardiac output to the heart of resilience is very small, or liquid drugs enter, regardless of quantity and speed should be extra careful
(4) Unless the blood pressure decreased significantly, generally do not have positive inotropic drugs, there is little help because not only be harmful.
(5) blood pressure decreased significantly, in order to ensure an adequate supply of aortic diastolic coronary blood flow, application of vasopressors.
(6) atrial fibrillation with rapid ventricular rate, heart rate control with digitalis.
(7) to maintain adequate blood volume, but to pay attention to input and speed, to prevent pulmonary edema.
(8) change of position sensitive patients should be slowly implemented.
(9) may take some time after mechanical ventilation
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