thiopental and Mitral-Valve-Stenosis

In 30 patients of rheumatic heart disease with mitral stenosis (MS) belonging to NYHA class II and III scheduled for closed mitral commissurotomy anaesthesia was induced with morphine 0.15 mg/kg followed by either thiopentone (group A, n = 15) or midazolam (group B, n = 15) titrated to produce sleep. Patients were intubated with pancuronium bromide in a dose of 0.12 mg/kg. Minimum mean arterial blood pressure following induction was significantly lower in thiopentone group (77 +/- 7 mm Hg) than midazolam group (85 +/- 6 mm Hg; P < 0.05). After intubation blood pressure was significantly higher in thiopentone group (99 +/- 8 mm Hg) than midazolam group patients (89 +/- 7 mm Hg). Heart rate was significantly higher in thiopentone treated patients both before and after endotracheal intubation. During surgery, three patients in group A had hypotensive episodes (mean arterial blood pressure 20% below basal at two successive readings 5 min apart) while one in group B had a hypotensive episode. Average duration of surgery was comparable between the two groups (102 +/- 15 and 95 +/- 18 min) and postoperatively there was no significant difference in sedation score and incidence of nausea and vomiting between the two groups.

Topics: Adult; Anesthesia, Intravenous; Female; Humans; Male; Midazolam; Mitral Valve Stenosis; Morphine; Thiopental

Physiological deadspace (VDphys) and arterial to end-tidal carbon dioxide tension difference [P(a-E)CO2] were calculated under anaesthesia in 27 patients with mitral stenosis planned for close mitral commissurotomy and in 15 healthy individuals for elective non-thoracic surgical procedures. A square wave inspiratory flow pattern and an end-inspiratory pause (25% and 10% of cycle time respectively) were given with a SERVO 900B ventilator used at respiratory rate of approximately 16 per min. An infra-red CO2 analyser was used to measure CO2 production and end-tidal CO2 concentration. Measurements were made prior to the start of the surgery after a minimum of 10 min of stable ventilation to avoid the effect of surgery. Patients with multiple stenosis had significantly higher VDphys (4.28 +/- 1.02 ml kg-1 as compared to 2.10 +/- 0.52 ml kg-1 in controls, P less than 0.001), higher P(a-E)CO2 [0.43 +/- 0.51 kPa as compared to -0.02 +/- 0.23 kPa, P less than 0.01] and lower respiratory system compliance (Crs). Péco2 was positively correlated with PaCO2 in both groups (P less than 0.01). PaO2 was lower in mitral stenosis patients and P(A-a)O2 negatively correlated to Crs (P less than 0.01).

Topics: Adult; Anesthesia, Intravenous; Carbon Dioxide; Female; Humans; Lung Compliance; Male; Mitral Valve Stenosis; Monitoring, Physiologic; Morphine; Oxygen; Pancuronium; Pulmonary Gas Exchange; Pulmonary Ventilation; Respiratory Dead Space; Thiopental; Tidal Volume

Topics: Age Factors; Anesthesia, General; Droperidol; Drug Combinations; Fentanyl; Hemodynamics; Humans; Ketamine; Mitral Valve Stenosis; Propanidid; Thiopental

Topics: Adult; Anesthesia, General; Anesthesia, Inhalation; Anesthesia, Intravenous; Arteries; Blood Pressure; Female; Heart Rate; Hexobarbital; Humans; Intubation, Intratracheal; Male; Middle Aged; Mitral Valve Stenosis; Nitrous Oxide; Pericarditis, Constrictive; Thiopental

Topics: Adult; Aortic Valve Stenosis; Blood Gas Analysis; Humans; Male; Mitral Valve Stenosis; Oximetry; Pleural Effusion; Pulmonary Edema; Radiography; Thiopental

Topics: Anesthesia; Anesthesiology; Blood Volume; Cardiac Surgical Procedures; Mitral Valve Stenosis; Thiopental; Thoracic Surgery

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesiology; Mitral Valve Stenosis; Muscle Relaxants, Central; Nitrous Oxide; Pain Management; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesiology; Ether; Mitral Valve Stenosis; Nitrous Oxide; Pain Management; Procaine; Thiopental