The Effect of Intravenous Injection of Amiodarone on Central Venous Pressure in Patients Undergoing Coronary Artery Bypass Graft Surgery

Document Type : Original Article (s)

Authors

1 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Anesthesiology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: The aim of this study was to determine the effect of intravenous amiodarone on the central venous pressure in patients undergoing coronary artery bypass graft surgery.Methods: In a clinical trial study, 76 patients underwent coronary bypass surgery were randomly divided in two groups of 38; in the first group, after exiting from cardiopulmonary bypass, 150 mg amiodarone was dissolved in 100 cc dextrose 5% serum and infused in 10 minutes. In the second group, with the same volume, dextrose 5% serum was injected to the patient over the same period. Patients in the two groups underwent anesthesia induction. Systolic, diastolic, mean arterial, and central venous pressures were measured in both groups at the time of induction, 15 minutes after separation from pump, and at the time of admission to the intensive care unit (ICU); the results of the two groups were compared.Findings: Systolic, diastolic, mean arterial and central venous pressures did not show any significant difference between the two groups (P > 0.05). During the study, 8 patients had electrocardiographic changes, of which 7 were from the control group and 1 from the amiodarone group (18.9% vs. 2.2%), and the difference between the two groups was significant (P = 0.02).Conclusion: It seems that administering amiodarone in the operative phase does not have a significant effect on central venous pressure and hemodynamic parameters; but administration of this drug significantly reduces the incidence of arrhythmia in patients undergoing coronary artery bypass graft.

Keywords

References

  1. Kaplan JA, Reich DL, Reich DL, Lake CL, Konstadt SN. Kaplan's cardiac anesthesia. Philadelphia, PA: Saunders; 2011. p. 215-7.
  2. Miller RD, Eriksson LI. Miller's anesthesia. London, UK: Churchill Livingstone; 2009. p. 286-90.
  3. Chatterjee S, Chaudhuri D, Vedanthan R, Fuster V, Ibanez B, Bangalore S, et al. Early intravenous beta-blockers in patients with acute coronary syndrome--a meta-analysis of randomized trials. Int J Cardiol 2013; 168(2): 915-21.
  4. Fujiwara H, Sakurai M, Namai A, Kawamura T. Effect of low-dose landiolol, an ultrashort-acting beta-blocker, on postoperative atrial fibrillation after CABG surgery. Gen Thorac Cardiovasc Surg 2009; 57(3): 132-7.
  5. Brandler E, Paladino L, Sinert R. Does the early administration of beta-blockers improve the in-hospital mortality rate of patients admitted with acute coronary syndrome? Acad Emerg Med 2010; 17(1): 1-10.
  6. Installe E, Schoevaerdts JC, Gadisseux P, Charles S, Tremouroux J. Intravenous amiodarone in the treatment of various arrhythmias following cardiac operations. J Thorac Cardiovasc Surg 1981; 81(2): 302-8.
  7. Dehghanzadeh S. Things we should know about CVP [Online]. [cited 2014 Jan 21]; Available from: URL: http://nurse-station.ir/archives/2925
  8. Charlier R, Deltour G, Baudine A, Chaillet F. Pharmacology of amiodarone, and anti-anginal drug with a new biological profile. Arzneimittelforschung 1968; 18(11): 1408-17.
  9. Singh BN. Amiodarone: historical development and pharmacologic profile. Am Heart J 1983; 106(4 Pt 2): 788-97.
  10. Charlier R. Cardiac actions in the dog of a new antagonist of adrenergic excitation which does not produce competitive blockade of adrenoceptors. Br J Pharmacol 1970; 39(4): 668-74.
  11. Kosinski EJ, Albin JB, Young E, Lewis SM, LeLand OS, Jr. Hemodynamic effects of intravenous amiodarone. J Am Coll Cardiol 1984; 4(3): 565-70.
  12. Levine JH, Massumi A, Scheinman MM, Winkle RA, Platia EV, Chilson DA, et al. Intravenous amiodarone for recurrent sustained hypotensive ventricular tachyarrhythmias. Intravenous Amiodarone Multicenter Trial Group. J Am Coll Cardiol 1996; 27(1): 67-75.
  13. Scheinman MM, Levine JH, Cannom DS, Friehling T, Kopelman HA, Chilson DA, et al. Dose-ranging study of intravenous amiodarone in patients with life-threatening ventricular tachyarrhythmias. The Intravenous Amiodarone Multicenter Investigators Group. Circulation 1995; 92(11): 3264-72.
  14. Yagdi T, Nalbantgil S, Ayik F, Apaydin A, Islamoglu F, Posacioglu H, et al. Amiodarone reduces the incidence of atrial fibrillation after coronary artery bypass grafting. J Thorac Cardiovasc Surg 2003; 125(6): 1420-5.
  15. Dorge H, Schoendube FA, Schoberer M, Stellbrink C, Voss M, Messmer BJ. Intraoperative amiodarone as prophylaxis against atrial fibrillation after coronary operations. Ann Thorac Surg 2000; 69(5): 1358-62.
  16. Bagshaw SM, Galbraith PD, Mitchell LB, Sauve R, Exner DV, Ghali WA. Prophylactic amiodarone for prevention of atrial fibrillation after cardiac surgery: A meta-analysis. Ann Thorac Surg 2006; 82(5): 1927-37.
  17. Haan CK, Geraci SA. Role of amiodarone in reducing atrial fibrillation after cardiac surgery in adults. Ann Thorac Surg 2002; 73(5): 1665-9.
  18. Shahbazy S, Falahat M. Need of inotrope in coronary artery bypass grafting with two methods of anesthesia. Razi J Med Sci 2005; 12(46): 343-8. [In Persian].
Journal of Isfahan Medical School
Volume 36, Issue 495 - Serial Number 495
July and August 2018
Pages 1044-1050

Files

History

  • Receive Date: 26 April 2018
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics