Preoperative preparation of patients with disorders of the cardiovascular system

Therapeutic sedation in this group of patients should be started after 8-12 days before surgery. In most patients the diffuse degenerative changes in the heart muscle, which clinically manifested dyspnea, palpitation, hypotension. Most often, these changes are associated with intoxication, anemia, electrolyte metabolism disorders (especially with the exchange of potassium), as well as violations of the acid-base balance.
A number of patients in this group are observed cardiac arrhythmia as extrasystoles, atrial fibrillation, paroxysmal tachycardia, bradycardia, etc.
Preparing for surgery in patients leads to the need to designate oxygen therapy, vitamins, cocarboxylase, vasodilator drugs (aminophylline, no-spa). Since the basis of cardiac arrhythmia is a change process of myocardial excitability and violation potassium metabolism, treatment should be aimed at reducing the excitability of the heart muscle, inhibition of pathological focus of excitation, and the normalization of potassium metabolism.
Such patients prescribed a diet rich in potassium (apricots, figs, apples, better grade Antonovka, cottage cheese), Panangin, potassium chloride, procainamide, quinidine, Isoptin. Patients with severe cardiac arrhythmia in the preoperative period should be administered intravenously depolarizes mix 100 ml of 20% glucose surges, 10 ml of a 10% solution of potassium chloride, 5 items. insulin, 10 mL of 1% lidocaine, 100 mg cocarboxylase.
Patients with severe heart rhythm for a few days before surgery is prescribed drugs that inhibit? -Adrenergic receptors (?-Blockers) and normalize rhythm (Obzidan, Inderal). When violations of intracardiac conduction (which clinically manifested bradycardia) appointed holinometiki (atropine, metatsin), sympathomimetics (izuprel), glucocorticoids, Panangin. At full or partial cross-blockade when bradycardia can be treated with difficulty, be a mixture of intravenous: atropine 0.1% solution — 0.5 ml, ephedrine 5% solution — 0.2 ml, aminophylline 2.4 % strength solution — 10 ml glucose 20% solution — 10 ml.
Patients suffering from hypertension, atherosclerosis, chest pain, for 7-8 days before surgery is prescribed vasodilators, sedatives (no-spa, aminophylline, papaverine, dibazol, tranquilizers, etc.).

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