Calcium channel blockade does not offer adequate protection from perioperative myocardial ischemia

• Published in: Anesthesiology (Philadelphia) Vol. 69; no. 3; pp. 343 - 347
• Main Authors: CHUNG, F, HOUSTON, P. L, CHENG, D. C. H, LAVELLE, P. A, MCDONALD, N, BURNS, R. J, DAVID, T. E
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01-09-1988
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Calcium - metabolism; Calcium Channel Blockers - therapeutic use; Coronary Artery Bypass; Coronary Disease - physiopathology; Coronary Disease - prevention & control; Drug Evaluation; Drug Therapy, Combination; Electrocardiography; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Hemodynamics - drug effects; Humans; Intraoperative Care - methods; Intraoperative Complications - physiopathology; Intraoperative Complications - prevention & control; Ion Channels - drug effects; Medical sciences; Prospective Studies; Human; Ischemia; Calcium antagonist; Myocardium; General anesthesia; Cardiovascular disease; Complication; Intraoperative; Sympathic nervous system; Beta blocking agent
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-198809000-00010

This study aimed to detect the difference in hemodynamic and electrocardiographic responses during the prebypass period in patients undergoing coronary bypass grafting who were receiving beta-adrenergic blocking drugs, calcium entry blocking drugs, or both beta-adrenergic and calcium entry blocking drugs. Electrocardiographic evidence of myocardial ischemia was noted significantly more frequently in patients receiving calcium entry blocking drugs alone at induction of anesthesia (P less than 0.03), skin incision (P less than 0.05), and sternotomy (P less than 0.002). Heart rate at sternotomy was significantly higher in patients receiving calcium entry blocking drugs (P less than 0.02) as compared to patients receiving beta-adrenergic blocking drugs or the combination of both drugs. In conclusion, patients treated with calcium entry blocking drugs alone had significantly higher incidence of perioperative ischemic ECG changes compared with patients receiving beta-adrenergic blocking drugs alone or in combination with calcium channel blocking drugs.