A comparison of haemodynamic changes using thoracic epidural anesthesia versus standard
balanced anaesthesia during on-pump coronary artery bypass grafting
Stříteský M.1, Rubeš D.1, Semrád M.2, Čermák T.1, Lipš M.1
1Klinika anesteziologie, resuscitace a intenzivní medicíny VFN a 1. LF UK v Praze 2II. chirurgická klinika kardiovaskulární chirurgie VFN a 1. LF UK v Praze |
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Summary:
Background: Thoracic epidural anaesthesia is a method with a short history starting in the early eighties.
Its use in cardiac surgery patients is presumed to reduce peri-operative and early post-operative ischaemia,
provide superior analgesia, shorten re-warming and extubation times and improve ventilation parameters.
Materials and Methods: A total of 30 patients undergoing CABG under general anaesthesia were randomized
to the thoracic epidural group (N = 15) and plain general anaesthesia group (N = 15).We observed haemodynamic
parameters (HR, BP, CI, SVRI, LVSWI), markers of analgesia, extubation time, time till awake
and early post-operative complication rates. Student’s and MANOVA tests were used for statistical analysis.
P values less than 0.05 were considered significant.
Results: We observed a lower heart rate and mean systemic pressure in the epidural anaesthesia group
while the cardiac index remained equal. Patients in the thoracic epidural group had better visual analgesic
score and shorter awakening and extubation times.
Conclusion: Thoracic epidural anaesthesia provides stable conditions in cardiac surgery. It can be used as
one of the fast-track methods.
Key words:
ischaemia – cardiac surgery – ventilation parameters
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