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The Annals of Thoracic Surgery, Vol 29, 123-129, Copyright © 1980 by The Society of Thoracic Surgeons
MP Sands, DH Dillard, EA Hessel 2d and DW Miller Jr
The halothane-diethyl ether azeotrope was evaluated in dogs as the
anesthetic agent for deep surface hypothermia with total circulatory arrest
for open-heart operation. All 10 animals given azeotrope in 100% oxygen
(O2) experienced atrial arrhythmias during cooling, and 1 had ventricular
fibrillation prior to the completion of cooling at 18 degrees to 20 degrees
C. After only 30 minutes' arrest, 8 of the 10 dogs had postoperative motor
disturbances. Administering the azeotrope in 95% O2 and 5% carbon dioxide
(CO2) yielded markedly improved results characterized by a rapid, smooth
cooling course, easy resuscitation following circulatory arrest, and rapid
rewarming, and 3 out of 10 dogs experienced mild motor disturbance after 60
minutes of circulatory arrest. This method, when compared with our standard
method of ether in 100% O2, resulted in reduced blood lactates and a
striking improvement in clinical status on the first postoperative morning.
In limited clinical trials, infants undergoing repair of congenital cardiac
defects have done well and responded as expected based on the laboratory
experience. Since the results with the azeotrope in 95% O2 and 5% CO2 were
at least as good as, and in several instances better than, those with the
standard method employing either, the nonexplosive characteristic of the
azeotrope warrants continued evaluation of this agent.
ARTICLES
Improved anesthesia for deep surface-induced hypothermia: the halothane- diethyl ether azeotrope
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