<Originals>Anesthesia for noncardiac surgery in patients with previous myocardial infarction

概要

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A restrospective analysis was made of patients with a history of myocardial infarction. Among 16,428 patients who had undergone non-cardiac surgery under general or regional (spinal or epidural) anesthesia between 1984 and 1988 in our hospital, 89 (0.54%) patients had had a previous myocardial infarction and one patient (1.1%) developed a postoperative reinfarction. The reinfarction rate within six months was 8.3%. We reviewed the recent literature and discussed the incidence of and the factors associated with peri-operative reinfarction. A history of recent infarction or hypertension, and abnormal preoperative ECG findings give warning of probable difficulties during anesthesia or in the early postoperative period. The most important factor associated with peri-operative myocardial infarction seemed to be intraoperative hypotension. Monitoring and ECG tracing should be extended throughout the postoperative period, for at least three days.
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