Comparative Assessment of the Cardiodepressive Effect in Traditional and Modified Induction Schemes of Anesthesia in Elderly Patients with Ischemic Heart Disease

Abstract

Most anesthetic drugs have a cardiodepressant action, which in elderly patients leads to a greater inhibition of the contractile functions of cardiomyocytes. Reducing the cardiodepressant action during the induction of anesthesia in elderly patients can reduce the incidence of peri- and postoperative complications and improve the safety of anesthesia in this category of patients. The aim of the study was to improve the safety of anesthesia in elderly patients with ischemic heart disease (IHD) by determining and applying an induction scheme with minimal cardiodepressant action. We examined 40 patients over 60 (in group 1, propofol and fentanyl were used for induction; in group 2, propofol, fentanyl, ketamine). Hemodynamic parameters were recorded at the following stages: 1) upon delivery of the patient to the operating room; 2) after administration of induction drugs; 3) after intubation; 4) 25 minutes after tracheal intubation. The echocardiography data were used to calculate the stroke volume index (SVI) and cardiac index (CI).