The Comparison of the Characteristics of "Nonspecific ST-T Change" Patients in Perioperative Periods / 대한마취과학회지

ABSTRACT

BACKGROUND: ST changes that do not fulfill the criteria of specific one-ST changes greater or equal to 1 mm and lasting over 1 minute-, are termed as "nonspecific". The term, "nonspecific ST-T change", has not had an important role as a guildeline of treatment. However, the incidence of "nonspecific ST-T changes" is estimated as not so negligible, and the relation to postoperative complications or the role as a coronary prognostic risk value has not been studied so far, so the authors thought to examine the general characteristics and course during the perioperative period of "nonspecific ST-T change" patients to conduct better anesthesia services. METHODS: From January 1st to June 30th in the year 2000, medical charts of patients who underwent an operation in one university hospital under general or regional anesthesia and whose preoperative electrocardiographic finding was "nonspecific ST-T changes" were reviewed. In the preoperative viewing of charts, demographic data, co-existing disease, findings in electrocardiography or echcardiography, and replies of a consultation to a cardiologist were reviewed. In the anesthesia records, nature of conducted anesthesia, agents, operation time and drugs acting on the cardiovascular system were reviewed. RESULTS: Incidence of "nonspecific ST-T changes" patients is 8.24%. Mean age is 54 +/- 16 yrs and the ratio of M F is about 1 2. The number of patients who had other medical diseases was 42, about 27%. The number of patients who underwent a preoperative echocardiography was 64, about 42%. Mean ejection fraction was 65 +/- 7%. The number of patients who consulted a cardiologist preoperatively was 44, about 22% and the majority of them were OK'd as "no problem". Administration of drugs acting on the cardiovascular system was done in 49 cases, about 33%. General anesthesia was conducted in 131 cases, regional anesthesia in 23 cases. CONCLUSIONS: In all cases, operations were performed without specific events or major complications. However more attention and risk evaluation is desirable in "nonspecific ST-T change" patients to conduct safer and more ideal anesthesia.