[Anesthesia used in minimally invasive myocardial revascularization surgery]. / Anestezija, naudojama minimalios apimties miokardo revaskulizacijos operacijai.

As myocardial revascularisation operations without cardiopulmonary bypass are getting more popular, more facts are found about their surgical techniques. However, the questions considering their anesthesia, the protection of myocardium and other are not widely analyzed. The specific features of anesthesia in cardiosurgery, such as methods of ventilation, combination of induction and general anesthesia with epidural anesthesia, usage of cardiac protection and ischemic preconditioning, monitoring, heparin management, usage of drugs, postoperative pain management are given in this article. As anesthesiological and surgical techniques are getting better and the professional skills of surgeons and anesthesiologists are improving, given data should improve the perspectives of minimally invasive cardio surgery operations and anesthesia in Lithuania.

[Magnesium sulfate usage for patients during cardiopulmonary bypass]. / Magnio sulfato naudojimas anestezijai operuojant isemine sirdies liga sergancius ligonius.

OBJECTIVE: Our study was performed in order to assess the effects of magnesium sulfate during coronary artery bypass surgery to evaluate whether perioperative intravenous infusion of magnesium, as an adjuvant agent for perioperative analgesia, affects a quality of anesthesia, reduces amounts of anesthetic and muscle relaxing drugs needed, affects adrenaline usage and nitroglycerine during anesthesia. METHODS: We investigated two patient groups, undergoing a coronary artery bypass surgery. Thirty patients (control group) have not received intravenous infusion of magnesium, 31 patients (magnesium group) have received 40 mg/kg of intravenous magnesium sulfate initially and a continuous 500 mg/h infusion during anesthesia. RESULTS: Patients in the magnesium group have received 1.01+/-0.07 mg of phentanyl, 9.33+/-0.72 mg of pipecuronium, 468+/-69 mg of tiopenthal, and 10.87+/-1.23 mg of midasolam; patients in the control group have received 1.02+/-0.07 mg of phentanyl, 10.4+/-1.2 mg of pipecuronium, 332+/-58 mg of tiopenthal and 10.4+/-1.2 mg of midasolam. Frequency of adrenaline usage in magnesium group was 6.67%, of nitroglycerine - 13.33% and nitropruside sodium - 6.67%, in control group patients have not received nitropruside sodium, frequency of adrenaline usage was 26.67% and nitroglycerine - 33.33%. CONCLUSIONS: Perioperative intravenous infusion of magnesium, as an adjuvant agent for anesthetics, does not reduce amounts of anesthetic and relaxant drugs needed, but it stabilized blood pressure fluctuations outside the critical range, without causing the pressure fall to a level that might risk undesirable side effects during surgery.