Clinical and functional reasons for internal thoracic artery Novocain blocks during in-patient coronary heart disease treatment
Abstract
Aim. Clinical and functional prove for using of modified Novocain block of internal thoracic arteries during inpatient coronary heart disease (CHD) treatment.
Material and methods. In total, 117 CHD patients, males and females of 32-78 years, were divided into two groups. Group I consisted of 50 CHD patients receiving antianginal therapy. Group II consisted of 67 CHD patients, who received not only standard antianginal treatment, but also Novocain blocks of internal thoracic arteries (3 procedures with 2-3-day intervals). Treatment effectiveness was assessed by clinical and instrumental methods: electrocardiogram (ECG), late ventricular potential (LVP) registration, Holter monitoring, echocardiography (EchoCG), and color tissue Doppler EchoCG (TDE).
Results. Internal thoracic artery block improved patients’ status: angina episodes’ number and / or intensity decreased, workload tolerance increased, night sleep normalized. Besides, ST depression and LVP disappeared or reduced, autonomous cardiac regulation improved, QT interval and extrasystole number decreased, that cut the risk of fatal arrhythmias. The method improved the velocity of basal LV segment movement, according to TDE. This inexpensive method, included into complex CHD management, reduced mean hospitalization time by 7 days.
Conclusion. Novocain internal thoracic artery block might be a method of choice in complex treatment of resistant angina.
About the Authors
I. A. Latfullin
Kazan State Medical University, Kazan
Russian Federation
Russian Federation
I. V. Bilalov
Kazan State Medical University, Kazan
Russian Federation
Russian Federation
R. R. Bilalova
Kazan State Medical University, Kazan
Russian Federation
Russian Federation
References
1. Билалов И.В. Клинико-анатомическое обоснование срединной стернотомии и профилактика ее осложнений. Дисс канд мед наук. Казань 1996.
2. Вишневский А.В., Вишневский А.А. Новокаиновая блокада и маслянно-бальзамические антисептики как особый вид патогенетической терапии. Москва, АМН СССР 1952; 169 с.
3. Латфуллин И.А., Ким З.Ф., Хромова А.М.. Депрессия сегмента ST у больных нестабильной стенокардией. Казань «Медицина» 2003; 126 с.
4. Швалев В.Н., Сосунов А.Н., Гуски Г. Морфологические основы иннервации сердца. Москва «Наука» 1992; 368 с.
5. Blomberg SG. Long-term home self-treatment with high thoracic epidural anesthesia in patients with severe coronary artery disease. Anesth Analg 1994; 79: 413-21.
6. Chester M, Hammond C, Leach A. Long-term benefits of stellate ganglion block in severe chronic refractory angina. Pain 2000; 87: 103-5.
7. Chester M.R. Диагностика, распространенность, эпидемиология и лечение рефрактерной стенокардии. Сердце и метаболизм 2003; 11: 6-10.
8. Leach A. Old ideas, new applications. Br J Anaesth 1998; 81: 113-5.
9. Weiner L, McCabe C, Ryan T. Identification of Patients with Left Main and Three Vessel Coronary Disease with Clinical and Exercise Test Variables.Am J Cardiol 1980; 46: 21-7.
Review
For citations:
Latfullin I.A., Bilalov I.V., Bilalova R.R. Clinical and functional reasons for internal thoracic artery Novocain blocks during in-patient coronary heart disease treatment. Cardiovascular Therapy and Prevention. 2005;4(5):50-56. (In Russ.)
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