Peri-operative evaluation by holter in elderly patients submitted to prostatectomy.
BACKGROUND
Male patients, aged over 65 years and with no history of heart disease, need the following tests as a preoperative evaluation: blood count, electrocardiogram and X-ray of the chest.


OBJECTIVE
To verify the presence of ischemic and heart rate changes and the impact of the anesthetic procedure on these patients. Also to verify, in this population, the value of continuous ambulatory monitoring as a preoperative evaluation, a procedure that is not recommended by current guidelines.


METHODS
In this protocol, we used continuous ambulatory monitoring (Holter System), in the perioperative period of 30 patients, aged over 65 years, who underwent transurethral resection of the prostate under spinal anesthesia.


RESULTS
In the preoperative and transoperative evaluations, frequent complex ventricular and supraventricular arrhythmias were observed, and also ischemic changes. In the transoperative recording, the patients who had ischemic episodes were the same ones who showed total ischemic burden of more than 60 minutes in the preoperative recording.


CONCLUSIONS
Ambulatory monitoring is not regarded as an appropriate procedure for the screening of myocardial ischemia, due to the characteristics and technical limitations of the method, especially in populations with a low prevalence of coronary disease. In this cross-sectional and observational study, we concluded that the Holter recordings provided additional information which could not be obtained by conventional electrocardiogram.
Cançado
Thais Orrico de Brito
TO
Sociedade Beneficiente Santa Casa de Campo Grande, Campo Grande, MS, Brasil. thaiscancado@terra.com.br
Leitão
Fernando Bueno Pereira
FB
Torres
Marcelo Luis Abramides
ML
Brito
Fábio Sândoli de
FS
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D015716:Electrocardiography, Ambulatory / Q000592:standards*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis*; D019990:Perioperative Care / Q000592:standards*; D011468:Prostatectomy; D018709:Statistics, Nonparametric