Prevention of Cardiac Complications at Adenomectomy

Abstract

Objective: to determine the efficient procedure of postoperative analgesia as a preventive means against the development of acute myocardial infarction (AMI) and its associated death in the early postoperative period of adenomectomy. Subjects and methods: The results of treatment were analyzed in 425 patients with concomitant ischemic heart disease who had undergone transvesical adenomectomy at the Unit of Urology, Emergency Care Hospital One, in January 1999 to December 2006. Results. Comparison using Fisher’s two-sided exact test showed that the incidence of AMI was statistically significantly higher in patients in whom postoperative analgesia had been made with trimeperidim on demand versus those in whom analgesia had been performed with the scheduled administration of nonsteroidal anti-inflammatory agents or prolonged epidural anesthesia (p=0.02; p=0.0267). AMI-related death occurred in the on-demand anesthesia group statistically significantly more frequently (p=0.0064; p=0.0294). Comparison employing the Newmann-Calse test indicated that the magnitude of pain was statistically significantly less when the elective anesthesia was applied (q=6.884; p<0.01; q=15.954; p<0.01). Conclusion. The use of the efficient anesthesia mode in the early postoperative period of adenomectomy may be one of the preventive means against the development of cardiac complications at adenomectomy and enhances the quality of life. Key words: postoperative analgesia, adenomectomy, acute myocardial infarction.