Epidural anesthesia improves outcome and resource use in cardiac surgery: a single-center study of a 1293-patient cohort

The Heart Surgery Forum
David BraccoPeriCARG Group, Montréal

Abstract

Thoracic epidural anesthesia (TEA) combined with general anesthesia in cardiac surgery has the potential to initiate earlier spontaneous ventilation and extubation, improved hemodynamics, less arrhythmia or myocardial ischemia, and an attenuated neurohormonal response. The aim of the current study was to characterize the correlation between TEA and postoperative resource use or outcome in a consecutive-patient cohort. The study was performed in a tertiary care, 3-surgeon, university-affiliated hospital that performs 350 to 400 cardiac surgeries per year. All 1293 adult patients who underwent cardiac surgery between July 1, 2002, and February 1, 2006, were included. Patients were assigned to anesthesiologists practicing TEA (TEA group, n = 506) or not (control group, n = 787) for cardiac surgery. The preoperative parameter values and Parsonnet scores for the 2 groups were similar. The 2 groups had the same distribution of surgery types. The TEA group presented with fewer intensive care unit (ICU) complications, such as delirium, pneumonia, and acute renal failure, and presented with better myocardial protection. The TEA group presented with a higher proportion of immediately postoperative extubations and with shorter ventilation...Continue Reading

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Citations

Jul 8, 2008·Annals of Cardiac Anaesthesia·Thomas M HemmerlingDavid Bracco
May 6, 2010·Annals of Cardiac Anaesthesia·Alexander J C Mittnacht, Ingrid Hollinger
Jul 3, 2013·Annals of Cardiac Anaesthesia·Thomas M HemmerlingNora Terrasini
Mar 20, 2009·Current Opinion in Anaesthesiology·Colin F Royse
Jul 8, 2009·Current Opinion in Anaesthesiology·Marie N HannaChristopher L Wu
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Sep 22, 2016·Best Practice & Research. Clinical Anaesthesiology·Stefan Schraag
Jun 25, 2021·Seminars in Cardiothoracic and Vascular Anesthesia·Jagan DevarajanKathirvel Subramaniam

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