Resumen
Objetivo: Realizar un análisis de la literatura sobre aspectos de los tratamientos preanestésicos y quirúrgicos, con foco en las cirugías cardiovasculares. Revisión bibliográfica: Las enfermedades cardiovasculares son la principal causa de muerte en Brasil y en el mundo y altos costos de salud pública en el país, promoviendo un gran número de cirugías cardiovasculares. La corrección del riesgo quirúrgico y el uso de riesgos es fundamental para la evaluación de las tasas de mortalidad por disminución o por complicaciones. El Índice de Riesgo Cardiaco Revisado -Criteria- es el principal criterio utilizado actualmente, basado en las comorbilidades preexistentes y el tipo de cirugía. Sin embargo, para cirugías cardiovasculares los requisitos deben ser más específicos, utilizando el EuroSCOREII. En cuanto al empleo de empleados, se necesitan recursos que operen con el propósito de cirugía y efectos adversos menos dañinos. Consideraciones finales: Corresponde al anestesiólogo, ya en la consulta preoperatoria, evaluar al paciente y planificar todas las acciones necesarias durante la cirugía cardiovascular y el manejo del dolor postoperatorio. El papel del anestesiólogo es fundamental para brindar la estabilidad necesaria para el trabajo del cirujano cardiovascular, considerando los altos riesgos del procedimiento.
Referencias
ALWARDT CM, et al. General anesthesia in cardiac surgery: a review of drugs and practices. The Journal of ExtraCorporeal Technology, 2005; 37(2): 227-35.
AMESS JAL, et al. Megaloblastic Hæmopoiesis In Patients Receiving Nitrous Oxide. The Lancet, 1978; 312(8085): 339-42.
BERWANGER O, et al. Association between pre-operative statin use and major cardiovascular complications among patients undergoing non-cardiac surgery: the VISION study. European Heart Journal, 2016; 37(2):177-85.
BONACCORSI HA, BURNS B. Perioperative Cardiac Management. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
BOUNDS CG, NELSON VL. Benzodiazepines. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
BRAUN LA, et al. Massage therapy for cardiac surgery patients – a randomized trial. The Journal of Thoracic and Cardiovascular Surgery, 2012; 144(6): 1453-9.
BUTTERWORTH JF, et al. Morgan and Mikhail’s clinical anesthesiology. 7th. ed. New York (NY): McGraw Hill, 2013.
BUYLAERT WA, et al. Cardiopulmonary Bypass and the Pharmacokinetics of Drugs: An Update. Clinical Pharmacokinetics, 1989; 17(1): 10-26.
CHAKRAVARTHY M. Modifying risks to improve outcome in cardiac surgery: An anesthesiologist’s perspective. Annals of Cardiac Anaesthesia, 2017; 20(2): 226-233.
CHENG MA, et al. Intravenous agents and intraoperative neuroprotection. Critical Care Clinics, 1997; 13(1): 185-99.
DEVEREAUX PJ, et al. Association Between Postoperative Troponin Levels and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. Journal of the American Medical Association, 2012; 307(21): 2295-2304.
FERRY N, DHANJAL S. Opioid Anesthesia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
FOLINO TB, et al. Propofol. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
FOT EV, et al. Automated Weaning from Mechanical Ventilation after Off-Pump Coronary Artery Bypass Grafting. Frontiers in Medicine, 2017; 21; 4: 31.
GERBERSHAGEN HJ, et al. Pain Intensity on the First Day after Surgery. Anesthesiology, 2013; 118(4): 934-44.
HERT SGD, et al. Sevoflurane but Not Propofol Preserves Myocardial Function in Coronary Surgery Patients. Anesthesiology, 2002; 97(1): 42-9.
KOHRS R, DURIEUX ME. Ketamine: Teaching an Old Drug New Tricks. Anesthesia & Analgesia, 1998; 87(5): 1186-93.
KRISTENSEN SD, et al. ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). European Heart Journal, 2014; 35(35): 2383-431.
LAYZER RB. Myeloneuropathy after Prolonged Exposure to Nitrous Oxide. The Lancet, 1978. 32(8102): 1227-30.
LEE TH, et al. Derivation and Prospective Validation of a Simple Index for Prediction of Cardiac Risk of Major Noncardiac Surgery. Circulation, 1999; 100(10): 1043-9.
LONGNECKER DE, et al. Principles and practice of anesthesiology. 2nd ed. St. Louis: Mosby; 1998.
LOPEZ EO, et al. Cardiovascular Disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
MONTEIRO GM, MOREIRA DM. Mortality in Cardiac Surgeries in a Tertiary Care Hospital of South Brazil. International Journal of Cardiovascular Sciences, 2015; 28(3): 200-205.
NASHEF SAM, et al. EuroSCORE II. European Journal of Cardio-Thoracic Surgery, 2012; 41(4): 734-44.
PATEL AY, et al. Cardiac Risk of Noncardiac Surgery. Journal of the American College of Cardiology, 2015; 66(19): 2140-2148.
PRINS C, et al. Cardiac surgery risk-stratification models. Cardiovascular Journal of Africa, 2012; 23(3): 160-164.
PUGSLEY MK. The diverse molecular mechanisms responsible for the actions of opioids on the cardiovascular system. Pharmacology & Therapeutics, 2002; 93(1): 51-75.
ROSENBAUM SB, et al. Ketamine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
ROSSEEL P, et al. Halothane treatment in life-threatening asthma. Intensive Care Medicine, 1985; 11(5): 241-6.
SINGH S, ZELTSER R. Cardiac Risk Stratification. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
SIQUEIRA ASE, et al. Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil. Arquivos Brasileiros de Cardiologia, 2017; 109(1): 39-46.
SKIBISKI J, ABDIJADID S. Barbiturates. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
SPRUNG J, et al. The Effects of Etomidate on the Contractility of Failing and Nonfailing Human Heart Muscle. Anesthesia & Analgesia, 2000; 91(1): 68-75.
TAN PS. The anaesthetic management of circulatory arrest. The British Journal of Hospital Medicine, 1990; 43(1): 36-41, 43-4.
TANAKA K, et al. Mechanisms of Cardioprotection by Volatile Anesthetics. Anesthesiology, 2004; 100: 707–721.
VAUGHN F, et al. Does Preoperative Anxiety Level Predict Postoperative Pain? AORN Journal, Mar 2007; 85(3): 589-604.
WARLTIER DC, et al. A Systematic Review of the Safety and Effectiveness of Fast-track Cardiac Anesthesia. Anesthesiology, 2003; 99: 982–987.
WHITE PF. Multimodal analgesia: its role in preventing postoperative pain. Curr Opin Investig Drugs, 2008; 9(1): 76-82.
WILLIAMS LM, et al. Etomidate. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2020.
ZUBRZYCKI M, et al. Assessment and pathophysiology of pain in cardiac surgery. Journal of Pain Research, 2018; 11: 1599–1611.
