Anaesthesiological management of heart surgery in adults - a survey

Our survey was intended to give an overview of current practice in anaesthe siology relating to heart surgery in Germany, All clinics (n = 77) carrying out heart surgery were sent a questionnaire, of which 55 relied in full, For preoperative diagnosis, ECG has top priority for 100 % of respondents, and cardiac catheterisation for 98 %, Lung function tests (64 %) and echo-c ardiography (46 %) were ranked lower. Premedication on the evening before t he operation was provided exclusively per os as monotherapy or combination therapy, The benzodiazepines flunitrazepam (51 %), potassium clorazept (29 %), and Lormatazepam (13 %) are most frequently prescribed. On the day of o peration, 52 clinics (95 %) give premedication per os, Frequently used drug s are flunitrazepam (55 %), midazolam (22 %), and potassium clorazepat (18 %), Narcosis is induced by Midazolam (64 %), etomidate (56 %), fentanyl (66 %), sufentanil (62 %), pancuronium bromide (90 %) and vecuronium (24 %), T o maintain narcosis, 35 clinics (64 %) apply narcotics continuously, 32 cli nics (58 %) intermittently, Intraoperative monitoring depends on the result s of preoperative cardiac investigations. Transoesophageal echo-cardiograph y is used in only 7 - 31 % of clinics (depending on operation) and monitori ng of cerebral function is carried out in 14 -18 %, Thirteen clinics (24 %) routinely administered catecholamines before ending extracorporeal circula tion, When treating low-output syndrome, cathecholamines are applied, in particul ar adrenalin (73 %), nitrocompounds (47 %), and phosphodiesterase blockers (42 %), In order to reduce the transfusion of homologous blood products and to avoi d illnesses associated with transfusions, more than half of the clinics res ponded that they used intraoperative haemodilution (67 %) or autologous blo od transfusion (53 %).