ABSTRACT
We report the case of a patient who presented, during a hip replacement, a cardiogenic shock following a myocardial infarction. After a successful resuscitation of three cardiac arrests, an intra-aortic balloon pump was inserted, then the patient could have been transferred to the nearest cardiac catheterization laboratory for a percutaneous dilatation of the right coronary artery, allowing the patient to have favourable outcome. Treatment of perioperative myocardial infarction is not really standardized. This case report depicts that in such critical condition, insertion of an intra-aortic balloon pump with early percutaneous angioplasty for acute peroperative myocardial infarction is a valuable option.
Subject(s)
Intraoperative Complications/therapy , Myocardial Infarction/therapy , Acute Disease , Aged , Angioplasty, Balloon, Coronary , Arthroplasty, Replacement, Hip , Cardiac Catheterization , Coronary Angiography , Electrocardiography , Heart Arrest/therapy , Humans , Intra-Aortic Balloon Pumping , Male , Monitoring, Intraoperative , ResuscitationABSTRACT
This prospective study was designed to evaluate the correlation between the electroencephalographic bispectral index (BIS) and the hypnotic component of anaesthesia (CA) induced by sevoflurane in 27 children and 27 adult patients. BIS and CA were compared at loss of consciousness (LOC) and on recovery of consciousness (ROC). Mean (SD) BIS decreased significantly at LOC in children and adults from 94 (2.7) to 87.4 (4) and from 96.2 (2) to 86.7 (4.4), respectively, without any difference between groups. Correlation coefficients (p) between BIS and CA at LOC were -0.761 in children and -0.911 in adults. BIS increased significantly at ROC in children and adults from 74.1 (4.2) to 86.7 (2) and from 80.2 (5) to 90.7 (3), respectively, without any difference between groups. Correlation coefficients between BIS and CA in ROC were -0.876 in children and -0.837 in adults. BIS values at ROC were not different from those at LOC in either group. These data demonstrate that BIS correlates with the hypnotic component of anaesthesia induced by sevoflurane in children as well as in adults.