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Canadian Journal of Anesthesia, Vol 6, 356-364, Copyright © 1959 by Canadian Anesthesiologists' Society

Electroencephalographic and Electrocardiographic Patterns during Open Heart Operations with the Use of Cardiopulmonary Bypass

EVA M KAVAN MD1, VERNE L BRECHNER MD1, RICHARD D. WALTER MD1, and LEONARD M LINDE MD1

1 Departments of Surgery (Anesthesia), Medicine (Neurology), and Pediatrics, University of California Medical Center, Los Angeles, Calif.

The most frequently occurring irregularities of the cardiac rhythm during 25 operations on the opened heart were sinus tachycardia, ventricular premature contractions, atrioventricular block, and ventricular tachycardia and fibrillation. Other changes noted in the configuration of the electrocardiogram included flattening and/or disappearance of P waves and flattening of T waves. In the majority of the patients, these changes were transient in character, they did not require any drug therapy, and they usually disappeared with temporary interruption or with termination of the surgical procedure.

It was considered a good sign if the configuration of the electrocardiogram, after cessation of the cardiopulmonary bypass, was identical or similar to that observed before perfusion.

Persistence of the electroencephalographic pattern of a light plane of anaesthesia before, during, and afer perfusion was usually consistent with a good prognosis. Reduction, both in potentials and frequency during extracorporeal circulation or after it, usually carried a poor prognosis.

In all instances, changes in electroencephalographic patterns were noted in all leads, thus indicating equal perfusion of all parts of the brain during extracorporeal circulation. We have no explanation as to why electroencephalographic evidence of brain damage developed in four patients postoperatively.

Note:

This work was supported by grant-in-aid no. H-2812, United States Public Health Service, National Institutes of Health, Bethesda, Maryland.

Read before the Annual Meeting of the Canadian Society of Anaesthetists in Montebello, Quebec, Canada, June 24, 1958.






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Copyright © 1959 by the Canadian Anesthesiologists' Society.