Document Detail

ST segment changes following retinal surgery.
MedLine Citation:
PMID:  9667345     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To describe the perioperative cardiac morbidity in adult patients undergoing retinal surgery using continuous Holter monitoring. DESIGN: Prospective study. SETTING: University hospital. PATIENTS: 56 patients scheduled for elective retinal surgery with local anesthesia. INTERVENTIONS: Patients were monitored continuously for 24 hours using a Holter recorder. Blood samples for creatine phosphokinase (CPK) and serum myocardial creatine phosphokinase (CPK-MB) were taken preoperatively and 24 hours postoperatively. The characteristics of myocardial ischemia were compared according to the number of risk factors for ischemic heart disease. MEASUREMENTS AND MAIN RESULTS: The overall incidence of perioperative myocardial ischemia was high: 26.7% (n = 15). These patients exhibited 41 episodes of ischemia with mean ST segment change from baseline of 2.2+/-0.7 mm. However, almost all (93.3%) ischemic episodes were silent. Patients with two risk factors or more had 77% more episodes of ischemia than patients with one risk factor (p < 0.005), and the duration of ischemia was 47+/-22.5 minutes compared with 34.8+/-27.5 minutes (p = NS). The first episode of ischemia occurred an average of 10 hours after surgery. No patient had intraoperative evidence of ischemia. Half of the ischemic episodes were associated with an increase in heart rate. No patient had evidence of acute myocardial infarction. CONCLUSION: Retinal surgery with local anesthesia is accompanied by a high incidence of postoperative myocardial ischemia. No negative outcome was correlated to the occurrence of postoperative myocardial ischemia. The significance of these findings has yet to be evaluated.
Y Gozal; B Drenger; J E Robertson; R F Davis
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  10     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-09-17     Completed Date:  1998-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  297-301     Citation Subset:  IM    
Department of Anesthesiology, Oregon Health Sciences University, Portland, USA.
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MeSH Terms
Middle Aged
Myocardial Ischemia / epidemiology,  etiology*
Postoperative Complications
Prospective Studies
Retina / surgery*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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