Seminars in Cardiothoracic and Vascular Anesthesia

 

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 5, No. 2, 166-183 (2001)
DOI: 10.1053/scva.2001.23719

Treatment of Perioperative Myocardial Ischemia

David A. Zvara, MD

Department of Anesthesiology, Medical Center Boulevard, Winston-Salem, NC 27157-1009

Prevention and treatment of myocardial ischemia re mains a central focus of perioperative care. Myocardial ischemia is best understood in terms of myocardial oxygen supply and demand ratios. Conventional ther apy includes nitrates, β-blockers, and calcium channel blockers. In all 3 drug classes, ischemia is reduced by either improving supply, decreasing demand, or both. More recent investigation evaluates these medications either as prophylactic therapy or as a component of long-term risk reduction for cardiac morbid events. Newer therapies, including anticoagulation, pain ther apy, normothermia, central neuroaxial techniques, and other therapies, are reviewed.


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