The Annals of Thoracic Surgery, Vol 23, 173-193, Copyright © 1977 by The Society of Thoracic Surgeons
Anesthesia and postoperative care for cardiac operations
S Tarhan, RD White and EA Moffitt
Almost three decades have passed since the establishment of open-heart
surgery, and in such a short life span the specialty has established itself
scientifically and reached a certain maturity. New techniques, better
understanding of the pathophysiology of cardiac problems, and the effective
use of new drugs constantly improve the results of operation. Greater
experience in anesthetic management and improved postoperative care will
contribute much to the success of this youngest surgical specialty. This
review outlines the current principles of anesthesia and postoperative care
of patients undergoing cardiac operations. Preanesthetic evaluation
provides guidance for anesthetic management, supportive techniques, and
postoperative care. During operations, light anesthesia is usually
sufficient for patients with cardiac disease and minimizes myocardial
depression. Monitoring must provide data on the physiological changes that
are taking place from moment to moment during and after operations.
Perfusion produces a highly abnormal state, and the severity of
complications varies with its duration. Introduction of new drugs has also
facilitated hemodynamic management during and after operations.
Postoperative care is based on careful observation of the patient and early
detection of trends, both of which lead to preventive rather than curative
treatment wheneven possible.
