Basic and clinical research of awake off pump CABG

基础研究2004年，研究了胸段硬膜外麻醉（TEA）对大鼠急性心肌模型冠状动脉血流量和心肌缺血耐受性的影响。本研究结果显示，TEA增加冠状动脉血流量，减少冠状动脉闭塞后心肌梗死面积。临床研究1)与全身麻醉相比，胸段硬膜外麻醉（TEA）能明显抑制交感神经的激活，并能降低搭桥过程中心律失常的发生率。2)监测无泵搭桥（OPCAB）过程中脑血流量和血氧饱和度。通过避免吻合时低血压，TEA比全麻更能稳定脑血流。3)我们报告了60例经TEA治疗的清醒离泵CABG （AOCAB）。全麻下，AOCAB组患者恢复快于OPCAB组。4)对20例AOCAB患者和20例标准全麻OPCAB患者进行了简易精神状态检查（MMSE）和Benton视觉保留测试。结果表明，AOCAB维持了较高水平的脑功能。

Basic researchIn 2004,we evaluated the effects of thoracic epidural anesthesia (TEA) to the coronary blood flow and the augmentation of tolerance for myocardial ischemia in acute myocardial models with rats.Results of this study presented that TEA increased the coronary blood flow and decreased the area of myocardial infarction after the coronary artery occlusion.Clinical research1)We reported thoracic epidural anesthesia (TEA) inhibited the activation of sympathetic nerve strongly compared to general anesthesia and furthermore TEA reduced arrhythmia during CABG.2)We monitored the brain blood flows and the O2 saturation during off-pump CABG(OPCAB). The TEA stabilized the brain blood flow more than general anesthesia by avoiding the low blood pressure during the anastomosis.3)We reported 60 awake off pump CABG (AOCAB) by using TEA. The patients with AOCAB recovered faster than them of OPCAB with general anesthesia.4)We studied Mini-mental State Examination (MMSE) and Benton Visual Retention Test to the 20 patients with AOCAB and 20 with standard general anesthesia OPCAB. This study resulted AOCAB maintained higher level function of brain.