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Our article after ten years: Awake cardiac surgery


Authors: M. Pořízka;  J. Kunstýř;  M. Lipš;  M. Stříteský
Published in: Anest. intenziv. Med., 32, 2021, č. 4-5, s. 229-233
Category: Review Article

Overview

Ten years ago, the results of prospective non-randomized study investigating perioperative management and clinical outcome of awake cardiac surgery patients undergoing procedure in sole epidural anaesthesia were published in European Journal of Cardiothoracic Surgery and Journal of Anaesthesia. This review article provides a critical assessment of the results of this work and further developments in this area, seen from a distance of one decade

Keywords:

cardiac surgery – Cardiopulmonary bypass – thoracic epidural anaesthesia – postoperative outcome


Sources
  1. Porizka M, Stritesky M, Semrad M, Dobias M, Dohnalova A, Korinek J. Standard blood flow rates of cardiopulmonary bypass are adequate in awake on‑pump cardiac surgery. Eur J Cardiothorac Surg. 2011; 39(4): 442–450. doi: 10.1016/j.ejcts.2010. 11. 054.
  2. Porizka M, Stritesky M, Semrad M, Dobias M, Dohnalova A. Postoperative outcome in awake, on‑pump, cardiac surgery patients. J Anesth. 2011; 25(4): 500–508. doi: 10.1007/s00540–011–1159–7.
  3. Murphy GS, Hessel 2nd EA, Groom RC. Optimal perfusion during cardiopulmonary bypass: an evidence‑based approach. Anesth Analg. 2009; 108(5): 1394–1417.
  4. Chaney MA. Intrathecal and epidural anesthesia and analgesia for cardiac surgery. Anesth Analg. 2006; 102(1): 45–64.
  5. Liu SS, Block BM, Wu CL. Effects of perioperative central neuraxial analgesia on outcome after coronary artery bypass surgery: a meta‑analysis. Anesthesiology. 2004; 101(1): 153–161.
  6. Scott NB, Turfrey DJ, Ray DA. A prospective randomized study of the potential benefits of horacic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. Anesth Analg. 2001; 93(3): 528–535. 
  7. Beattie WS, Badner NH, Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta‑analysis. Anesth Analg. 2001; 93(4): 853–858.
  8. Ballantyne JC, Carr DB, deFerranti S, Suarez T, Lau J, Chalmers TC, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta‑analyses of randomized, controlled trials. Anesth Analg. 1998; 86(3): 598–612.
  9. Ziyaeifard M, Azarfarin R, Golzari SE. A Review of Current Analgesic Techniques in Cardiac Surgery. Is Epidural Worth it? J Cardiovasc Thorac Res. 2014; 6(3): 133–140. doi: 10.15171/jcvtr.2014.001.
  10. Chakravarthy M. Future of awake cardiac surgery. J Cardiothorac Vasc Anesth. 2014; 28(3): 771–777. doi: 10.1053/j.jvca.2013. 03. 005.
  11. Wilson A, Gray D, Karakiozis J, Thomas J. Advanced endotracheal tube biofilm stage, not duration of intubation, is related to pneumonia. J Trauma Acute Care Surg. 2012; 72(4): 916–923. doi: 10.1097/TA.0b013e3182493a10.
  12. Hsu CW, Sun SF. Iatrogenic pneumothorax related to mechanical ventilation. World J Crit Care Med. 2014; 3(1): 8–14. doi: 10.5492/wjccm.v3.i1. 8.
  13. Paulissian R, Salem MR, Joseph NJ, Braverman B, Cohen HC, Crystal GJ, et al. Hemodynamic responses to endotracheal extubation after coronary artery bypass grafting. Anesth Analg. 1991; 73(1): 10–15. doi: 10.1213/00000539–199107000–00003. 14. Bottio T, Bisleri G, Piccoli P, Negri A, Manzato A, Muneretto C. Heart valve surgery in a very high‑risk population: a preliminary experience in awake patients. J Heart Valve, DiS. 2007; 16(2): 187–194.
  14. Aoki K, Kanazawa H, Okamoto T, Takahashi Y, Nakazawa S, Yamazaki Y. Awake partial sternotomy pacemaker implantation under thoracic epidural anesthesia. Gen Thorac Cardiovasc Surg. 2009; 57(8): 418–420. doi: 10.1007/s11748–009–0401–9.
  15. Weissman C. Pulmonary function after cardiac and thoracic surgery. Anesth Analg. 1999; 88: 1272–1279.
  16. Samuels LE, Kaufman MS, Morris RJ, Promisloff R, Brockman SK. Coronary artery bypass grafting in patients with COPD. Chest. 1998; 113: 878–882. 
  17. Chakravarthy M, Jawali V, Patil TA, Jayaprakash K, Kolar S, Joseph G, et al. Conscious cardiac surgery with cardiopulmonary bypass using thoracic epidural anesthesia without endotracheal general anesthesia. J Cardiothorac Vasc Anesth. 2005; 19(3): 300–305. doi: 10.1053/j.jvca.2005. 03. 005.
  18. Chakravarthy M. Technique of awake cardiac surgery, Techniques in Regional Anesthesia & Pain Management. 2008; 12: 87–98. doi: 10.1053/j.trap.2007. 10.
  19. Chakravarthy M, Jawali V, Patil TA, Jayaprakash K, Shivananda NV. High thoracic epidural anesthesia as the sole anesthetic for performing multiple grafts in off‑pump coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2003; 17(2): 160–164. doi: 10.1053/jcan.2003. 40.
  20. Karagoz HY, Sönmez B, Bakkaloglu B, Kurtoglu M, Erdinc M, Türkeli A, et al. Coronary artery bypass grafting in the conscious patient without endotracheal general anesthesia. Ann Thorac Surg. 2000; 70(1): 91–96.
  21. Kessler P, Aybek T, Neidhart G, Dogan S, Lischke V, Bremerich DH, et al. Comparison of three anesthetic techniques for off‑pump coronary artery bypass grafting: general anesthesia, combined general and high thoracic epidural anesthesia, or high thoracic epidural anesthesia alone. J Cardiothorac Vasc Anesth. 2005; 19(1): 32–39.
  22. Stritesky M, Semrad M, Kunstyr J, Hajek T, Demes R, Tosovsky J. On‑pump cardiac surgery in a conscious patient using a thoracic epidural anesthesia--an ultra fast track method. Bratisl Lek Listy. 2004; 105(2): 51–55.
  23. Hirofuji A, Kanda H, Kitani Y, Kamiya H. Awake Surgical Mitral Valve Repair after Transcatheter Aortic Valve Replacement. Thorac Cardiovasc Surg Rep. 2021; 10(1): e15–e17. doi: 10.1055/s-0040–1718774.
  24. Kanda H, Kamiya H, Takahoko K, Yamaya S, Kudo E, Kunisawa T. Awake double valve surgery without general anesthesia. J Clin Anesth. 2019; 56: 117–118. doi: 10.1016/j.jclinane.2019. 01. 025.
  25. Pompeo E. Awake thoracic surgery--is it worth the trouble? Semin Thorac Cardiovasc Surg. 2012; 24(2): 106–114. doi: 10.1053/j.semtcvs.2012. 06. 010.
  26. Bertolaccini L, Zaccagna G, Divisi D, Pardolesi A, Solli P, Crisci R. Awake non‑intubated thoracic surgery: an attempt of systematic review and meta‑analysis. Video‑assist Thorac Surg. 2017; 2: 59. http://dx.doi.org/10.21037/vats.2017. 08. 17.
  27. Zhang S, Wu X, Guo H, Ma L. Thoracic epidural anesthesia improves outcomes in patients undergoing cardiac surgery: meta‑analysis of randomized controlled trials. Eur J Med Res. 2015; 20(1): 25. doi: 10.1186/s40001–015–0091-y.
  28. Wong WT, Lai VK, Chee YE, Lee A. Fast‑track cardiac care for adult cardiac surgical patients. Cochrane Database Syst Rev. 2016; 9(9): CD003587. doi: 10.1002/14651858. CD003587.pub3.
  29. Rosen DA, Hawkinberry DW 2nd, Rosen KR, Gustafson RA, Hogg JP, Broadman LM. An epidural hematoma in an adolescent patient after cardiac surgery. Anesth Analg. 2004; 98: 966–969.
  30. Sharma S, Kapoor MC, Sharma VK, Dubey AK. Epidural hematoma complicating high thoracic epidural catheter placement intended for cardiac surgery. J Cardiothorac Vasc Anesth. 2004; 18: 759–762.
  31. Royse CF. High thoracic epidural anaesthesia for cardiac surgery. Curr Opin Anaesthesiol. 2009; 22(1): 84–87. doi: 10.1097/ACO.0b013e32831a40b6.
  32. Hemmerling TM, Cyr S, Terrasini N. Epidural catheterization in cardiac surgery: the 2012 risk assessment. Ann Card Anaesth. 2013; 16(3): 169–177. doi: 10.4103/0971–9784.114237.
  33. Horlocker TT, Vandermeuelen E, Kopp SL, Gogarten W, Leffert LR, Benzon HT. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence‑Based
  34. Guidelines (Fourth Edition). Reg Anesth Pain Med. 2018; 43(3): 263–309. doi: 10.1097/AAP.0000000000000763.
  35. Stříteský M, Lipš M, Rubeš D, Cermak T, Pavlíková M, Lindner J. Anestezjologia i intensywna terapia A retrospective analysis of high thoracic epidural anesthesia and analgesia in cardiac surgery over the 1995–2002 period. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2005; 2(4): 58–62.
  36. Porizka M, Koudelkova K, Kopecky P, Porizkova H, Dohnalova A, Kunstyr J. High thoracic anesthesia offers no major benefit over general anesthesia in on‑pump cardiac surgery patients: a retrospective study. Springerplus. 2016 Jun 21; 5(1): 799. doi: 10.1186/s40064–016–2541–6.
  37. Scarsini R, De Maria GL, Joseph J, Fan L, Cahill TJ, Kotronias RA, et al. Impact of Complications During Transfemoral Transcatheter Aortic Valve Replacement: How Can They Be Avoided and Managed? J Am Heart Assoc. 2019; 8(18): e013801. doi: 10.1161/JAHA.119.013801.
  38. Moss S, Doyle M, Nagaraja V, Peeceeyen S. A systematic review and meta‑analysis of the clinical outcomes of TAVI versus SAVR in the octogenarian population. Indian J Thorac Cardiovasc Surg. 2020; 36(4): 356–364. doi: 10.1007/s12055–019–00912–0.
  39. Kanda H, Kamiya H, Sugawara A, Yamaya S, Onodera Y, Toyama Y, et al. Minimally Invasive Awake Mitral Valve Surgery and Cardiopulmonary Bypass Without General Anesthesia. Ann Thorac Surg. 2019; 107(4): e247–e248. doi: 10.1016/j.athoracsur.2018. 07. 090.
Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

Article was published in

Anaesthesiology and Intensive Care Medicine

Issue 4-5

2021 Issue 4-5

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