Hemodynamic Evaluation of Anesthetics and Positioning by Transesophageal Echocardiography

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After obtaining informed consent from each patient, we studied as follows.1.We evaluated effect of pancuronium bromide (PB) and vecuronium bromide (VB) on the left ventricular function of surgical patients using the transesophageal echocardiography (TEE). PB caused significant increases in Heart rate (HR), blood Pressure (BP) and cardiac index (CI). The enhanced HR probably caused the increase in CI,because there was no singificant increase in stroke volume index (SVI).PB had no effect on left ventricular systolic functions. VB didn't cause any significant changes in hemodynamic performance.2.We investigated effect of prone positioning on cardiac function using TEE.In the prone position, there was significant reduction in left ventricular volume (LVV), diminishment of systolic pulmonary venous flow velocity (PVFV) and pulmonary venous velocity time integral (PVVTI) and enhancement of diastolic PVFV and PVVTI.SVI and CI did not change significantly in the prone position. These changes were probably due to a decrease in the venous return due to inferior vena caval compression, and decreased left ventricular compliance due to increased intra-thoracic pressure in the prone position.3.We performed this study to estimate changes in coronary sinus flow (CSF) during coronary artery bypass grafting (CABG) by TEE.All velocities and VTI of CSF increased significantly after CABG,which was probably due to increased coronary blood flow after CABG.The results of this study indicate the feasibility of this new perioperative method of CABG evaluation.