Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 mic...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 1986-02, Vol.64 (2), p.157-164
Main Authors: KLEINMAN, B, HENKIN, R. E, GLISSON, S. N, EL-ETR, A. A, MAMDOUH BAKHOS, SULLIVAN, H. J, MONTOYA, A, PIFARRE, R
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Coronary Artery Bypass
Coronary Circulation
Electrocardiography
Female
Fentanyl
General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation
Halothane
Heart - diagnostic imaging
Heart Rate
Hemodynamics
Humans
Male
Medical sciences
Middle Aged
Perfusion
Pulmonary Wedge Pressure
Radioisotopes
Radionuclide Imaging
Regional Blood Flow
Thallium
Thiopental
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Summary:Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques.
ISSN:0003-3022
1528-1175
DOI:10.1097/00000542-198602000-00005