A comparison of haemodynamic changes using thoracic epidural anesthesia versus standard balanced anaesthesia during on-pump coronary artery bypass grafting

Overview

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