Comparison of the effect of two anaesthesia methods in preventing perioperative myocardial infarction in patients with cardiac risk undergoing total knee arthroplasty
we enrolled 50 patients of both sex of American society of Anesthesiologists (ASA) physical status II where the presence and/or risk for coronary artery disease (CAD) as well as planned lower extremity surgery was considered. Presence of CAD was ascertained by history of myocardial infarction and diagnosis of typical angina or atypical angina with a positive stress test \& ECG finding. Risk for CAD included age (\> 65 years old), hypertension, smoking habit, blood cholesterol (\>240 mg/dL), and diabetes. who met the selection criteria were randomly allocated to 1 of the 2 groups (25 patients) each: * Group (G): received general anaesthesia followed by IV patient-controlled analgesia (IV PCA). * Group (F): received spinal anaesthesia followed by continuous ultrasound guided femoral never block once the anaesthesia-induced motor block resolved. We aimed to compare the effect of the two anaesthesia methods in preventing perioperative myocardial infarction in patients with cardiac risk undergoing total knee arthroplasty. The primary outcome included perioperative levels of brain natriuretic peptide \& cardiac troponins. Secondary outcomes included postoperative operative pain assessment using visual analogue scale, total amount of analgesic consumption, patient satisfaction \& cardiovascular complications (myocardial infarction, arrhythmias , heart failure, hypotension, hypertension \& the need for inotropic agents).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
50
intraoperative general anaesthesia followed by postoperative IV patient analgesia
patient received spinal followed by continuous ultrasound guided femoral never block.
Alexandria University Faculty of Medicin
Alexandria, Egypt
brain natriuretic peptide
marker for myocardial infarction
Time frame: immediately preoperatively
brain natriuretic peptide
marker for myocardial infarction
Time frame: after 48 hours post-operatively
visual analogue scale
a score to evaluate postoperative pain intensity
Time frame: after 6 hour postoperatively
amount of analgesic consumption
the total amount of analgesic consumed by each patient
Time frame: after 48 hour postoperatively
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