Canadian Journal of Anesthesia, Vol 19, 20-34, Copyright © 1972 by Canadian Anesthesiologists' Society

An Anaesthetic Application of Serum Digoxin Radioimmunoassay

¹ Department of Anaesthesia and the Department of Nuclear Medicine, Vancouver general Hospital, Vancouver, BC

Sevral points of interest have been demontrated.

Serial testing has not shown eny evidence of significant redistribution of digoxin from peripheral tissues during spinal anaesthesia, general anaesthesia or cardioversion. Serum levels remained almost constant during surgery and in the early post-operative period. Major blood loss and replacement during cardio-pulmonary bypass has not caused a significant loss of dioxin.

Four clinical applications of the test are presented in Table II.

Preoperatively some patients are inadequately or excessively digitalized at the time of surgical stress. While dioxin intoxication is dangerous, inadequate treatment or protracted preoperative withdrawal of therapy may precipitate acute postoperative cardiac failure.

Radioimmunoassay provides the clinician with a technique of determining the preoperative serum digoxin and a rational approach to preoperative adjustments in therapy, so that the patient may come to surgery with an improved dioxin concentration. Preoperative control may diminish the need for aggressive use of digoxin in the early postoperative period.

Note:

presented in the Resident's Competition of the 1971 Canadian Anaesthetists' Society Meeting, June 29, 1971