[Infarction in the per-operative period: check-up, results, treatment, surveillance].
Peroperative infarction (POI) is a frequent and serious event, which is associated with an increase in morbidity and mortality; the risk is aggravated to varying degrees by the techniques of anaesthesia and surgery used. The preoperative evaluation of risk, which combines clinical and paraclinical criteria is described in the algorithm of the new AHA/ACC guidelines. In order to avert these ischemic episodes, beta-blockers must be continued or introduced during vascular surgery. In other types of surgery, they must be considered. It is difficult to diagnose MI in a per-operative context. The electrocardiogram print out and troponin kinetics will identify patients in the postoperative phase that should be oriented towards cardiovascular evaluation and therapy.
Chulliat
P A
PA
Départment d'anesthésie, CHU Bocage, France.
Lorgis
L
L
Richard
C
C
Pernet
C
C
Lagrost
A C
AC
Merel
A L
AL
Zeller
M
M
Cottin
Y
Y
Girard
C
C
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000768:Anesthesia, General / Q000009:adverse effects; D004562:Electrocardiography; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007431:Intraoperative Complications; D007432:Intraoperative Period; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D017202:Myocardial Ischemia / Q000209:etiology / Q000517:prevention & control; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D011300:Preoperative Care; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D014336:Troponin / Q000032:analysis; D014656:Vascular Surgical Procedures / Q000009:adverse effects
D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014336:Troponin; D020097:Natriuretic Peptide, Brain