Effects of preoperative digitalisation on postoperative left heart performance and incidence of complications following hip surgery. First results of a prospective study

  • Ch. Maier
  • W. Knippenberg
Conference paper

Summary

The postoperative course may be complicated by cardiac events, especially heart failure. In this study the influence of preoperative digitalisation was investigated on the occurrence of postoperative cardiac complications.

38 nondigitalised patients over 50 years undergoing hip replacement were investigated. After randomization the patients were distributed into 3 groups prospectively:
  1. Group A:

    Control (without digitalis; n = 13)

     
  2. Group B:

    Preoperative digitalisation with 1.0 mg digitoxin and maintenance dosis (MD) of 0.1 mg/die digitoxin (n = 13).

     
  3. Group C:

    Digitalisation with 0.75 mg and MD of 0.07 mg/die digitoxin (n = 12).

     
Preoperative cardiac status and results of measured STI were comparable in all three groups. During the first week postoperatively the clinical course and LV-function, measured by systolic time intervals (STI), were studied according to a pre-determined schedule.
  1. 1.

    Severe cardiac complications (such as severe heart failure, angina pectoris, tachyarrhythmia) were significantly more frequent in the control group. In 6 patients from this group the need for digitalisation due to heart failure or tachycardia occured.

     
  2. 2.

    The STI were prolonged significantly in the nondigitalised patients 7 days postoperatively. This postoperative deterioration of LV performance was prevented by preoperative digitalisation, as demonstrated in the postoperatively unchanged STI in digitalised patients of group B and C.

     
  3. 3.

    The dose of digoxin was not significant of either the clinical course or in the alteration of STI.

     
  4. 4.

    We conclude from this study that preoperative digitalisation with a low dose of digitoxin may be useful for the reduction of postoperative cardiac risks in elderly patients.

     

Keywords

Fentanyl Glycoside Digoxin Ethrane Digitoxin 

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References

  1. 1.
    Goldman L (1983) Ann Surg 198: 780CrossRefGoogle Scholar
  2. 2.
    Hartung H-J et al (1984) Anaesthesist 33: 417PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • Ch. Maier
    • 1
  • W. Knippenberg
    • 2
  1. 1.Department of AnesthesiaChristian-Albrechts-UniversitätKielWest Germany
  2. 2.Department of AnesthesiaChristian-Albrechts-UniversitätKielWest Germany

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