Peri-operative silent myocardial ischaemia in patients undergoing lower limb joint replacement surgery:: an indicator of postoperative morbidity or mortality

被引:12
作者
French, GWG [1 ]
Lam, WH [1 ]
Rashid, Z [1 ]
Sear, JW [1 ]
Foëx, P [1 ]
Howell, S [1 ]
机构
[1] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Anaesthet, Oxford OX3 9DU, England
基金
英国惠康基金;
关键词
surgery; orthopaedic; complications; cardiovascular disease; heart; silent myocardial ischaemia;
D O I
10.1046/j.1365-2044.1999.00713.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
One hundred and twenty-seven patients undergoing major lower limb joint replacement surgery were studied to determine the incidence of silent myocardial ischaemia and to ascertain any link between pre-operative cardiac risk factors, silent myocardial ischaemia and postoperative morbidity. Patients underwent ambulatory ECG monitoring for 4 days (on the pre-operative night and for 3 days postoperatively). Postoperative cardiorespiratory symptomatology and morbidity was assessed by questionnaire at 3 months. Eighty-seven patients had risk factors for silent myocardial ischaemia; 42 patients (30 with risk factors) had peri-operative silent myocardial ischaemia. The median ischaemic loads (range) were 1.04 (0.32-13.31) min.h(-1) pre-operatively and 5.53 (0.26-56.39), 6.69 (0.04-42.71) and 1.23 (0.1-53.74) min.h(-1) on postoperative days 1-3, respectively. Risk factors did not predict the occurrence of silent myocardial ischaemia or an increased ischaemic load pre-operatively or overall postoperatively. New symptoms (chest pain, palpitations, breathlessness or fatigue) were associated with both silent myocardial ischaemia and ischaemic load (p < 0.05). Thus cardiac risk factors do not predict the occurrence of silent myocardial ischaemia or adverse outcome. Peri-operative silent myocardial ischaemia was associated with increased postoperative fatigue.
引用
收藏
页码:235 / 240
页数:6
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