Abstract:
BACKGROUND AND OBJECTIVE:Amiodarone is very effective against a variety of dysrhythmias but has poor pharmacodynamic properties and many undesired side-effects. Its short- and rapid-acting derivative E 047/1 may circumvent some of these drawbacks. It is easier to titrate while retaining the high efficacy of amiodarone and may have acceptable influences on haemodynamics and cardiac conduction in patients who develop serious, destabilizing ventricular tachydysrhythmias after cardiac surgery. METHODS:Testing E 047/1 was performed prospectively in two consecutive phase II open, clinical studies. Out of 504 patients scheduled for surgery using cardiopulmonary bypass for coronary artery grafting and/or valve repair, 35 developed serious, haemodynamically destabilizing ventricular dysrhythmias (Lown 2-Lown 4b) after surgery and were treated with a 1 mg kg(-1) (pilot study, n = 15) or randomized to a 2 or 3 mg kg(-1) bolus of E 047/1, followed by a 1 mg kg(-1) h(-1) continuous infusion for 2 h (n = 10 in each group). Dysrhythmias, PQ, QTc intervals and haemodynamics using the thermodilution technique were evaluated for up to 24 h after drug initiation. RESULTS:At the time of final inclusion the patients had between 6 and 12 (or more) ventricular ectopics per minute. Within the first 2-3 min of application in the pilot trial E 047/1 induced a decrease of ventricular dysrhythmias to between 0 and 4 per min, a decrease that held for the duration of treatment. The area under the curve decreased from 434 (322, 855; median, quartiles) to 114 (9, 477, P < 0.01) events per hour. In the randomized trial, E 047/1 administered in either dose rapidly reduced ventricular dysrhythmias at least as effectively as in the pilot trial 565 (478, 701) to 33 (8, 238, P < 0.05) after a 2 mg bolus; 482 (339, 482) to 95 (13, 540, P < 0.01) events per hour after a 3 mg bolus. Approximately 4-6 h after drug termination, dysrhythmias reappeared in the majority of patients. In only three patients did the incidence of dysrhythmias return to inclusion criteria levels. In contrast to the pilot trial, in the randomized trial there was a slight increase of mean pulmonary artery pressure, central venous pressure and pulmonary arterial wedge pressure and a slight decrease of LCWI in both groups. E 047/1 did not cause QTc prolongation. CONCLUSIONS:E 047/1 appears to be a safe alternative to amiodarone in the perioperative setting of cardiac surgery when serious, destabilizing dysrhythmias occur.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Gombotz H,Vicenzi M,Mahla E,Rehak P,Metzler Hdoi
10.1017/s0265021502000042subject
Has Abstractpub_date
2002-01-01 00:00:00pages
23-31issue
1eissn
0265-0215issn
1365-2346journal_volume
19pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND AND OBJECTIVE:For cannulation of the internal jugular vein (IJV), ultrasound increases the number of first pass successes and reduces the rate of mechanical complications. A frequent complication of IJV access is the accidental injury of the common carotid artery (CCA), which can be dangerous in some circums...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328341a492
更新日期:2011-05-01 00:00:00
abstract::Simulation is often used for training personnel in activities where the consequences of inappropriate actions are serious. We report a realistic training simulator, which can reproduce practically all potential malfunctions in the anaesthetic machine. Using actual standard equipment (Dameca 10750), the interior of the...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group)...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021503000899
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. OBJECTIVE:To assess the pre and postoperative prevalence and perioperative management of anaemia in patients undergoing elective orthopaedic surgery in Europe. DESIGN:An observational study; data ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000202
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Septic encephalopathy is believed to be a result of neuro-inflammation possibly triggered by endotoxins, such as lipopolysaccharides (LPS). Modulation of the immune system is a property of volatile anaesthetics. OBJECTIVE:We aimed to investigate the systemic and cerebral inflammatory response in a LPS-induc...
journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2010-01-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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pub_type: 杂志文章
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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abstract::The rate of failed spinal anaesthesia, defined as the need for unplanned general anaesthesia, was evaluated in a prospective study involving 137 patients undergoing transurethral resection of the prostate (TURP). The incidence of sensations at the operative site which did not require general anaesthesia was also evalu...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
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abstract:BACKGROUND AND OBJECTIVE:Unilateral spinal anaesthesia is a useful anaesthesia technique in lower abdominal surgery, especially in an outpatient setting. Patient posture is pivotal in the achievement of unilateral anaesthesia. Nevertheless, no studies have elucidated the influence of patient posture during the anaesthe...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2006-06-01 00:00:00
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journal_title:European journal of anaesthesiology
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更新日期:2005-05-01 00:00:00