PROPHYLACTIC DIGITALIZATION IN OPEN THORA COTOMY

Prophylactic digitalization is still recommended after open lung surge ry in order to prevent cardiac arrhythmias in the postoperative period . Since a beneficial effect of this potentially harmful medication is only poorly documented, we conducted a prospective randomized trial. P atients undergoing elective open lung surgery were divided into two gr oups one of which received digoxin postoperatively, the other not. Ran domization was performed independently in three groups with regard to the extent of surgery, i.e. pneumonectomies in patients of any age, (b i-)lobectomies in patients > 50 and other (less extended) operations i n patients >60. Patients who were either too young for either group or who had already taken digoxin before surgery were followed separately . Monitoring was performed continuously in the ICU and conventional EC G was registered after 24, 48 and 72 hours and weekly until dismission . - Cardiac arrhythmias are very frequent in the early postoperative p eriod with a maximum between the third and the fifth postoperative day . Any kind of arrhythmias were present in 19 of 30 patients (63%) comp ared to 14 of 35 patients (40%) in the control group. Symptomatic arrh ythmias that needed treatment occurred in 11.4% of the control group, but in 33.3% of the patients with prophylactic digitalization. We ther efore conclude that a general prophylactic digitalization after open l ung surgery is not indicated, but that arrhythmias should be treated i ndividually.