July 1, 1994Anesthesia & Analgesia
Cardiac Sympathovagal Balance and Peripheral Sympathetic Vasoconstriction
Why the study?
Does epidural anesthesia compared to general anesthesia alter cardiac sympathovagal balance and peripheral vasoconstriction in patients undergoing radical retropubic prostatectomy?
Population
20 consecutive patients scheduled for radical retropubic prostatectomy
Comparison
Epidural anesthesia (EA) vs General anesthesia (GA)
Design
RCT, Randomized
Follow-up
Intraoperative and postoperative periods
Authors
Discussion
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Member takes
Implication
May prompt caution favoring general anesthesia to limit sympathetic drive in prostatectomy; challenges assumptions of epidural autonomic superiority.
Structured PICO
Does epidural anesthesia compared to general anesthesia alter cardiac sympathovagal balance and peripheral vasoconstriction in patients undergoing radical retropubic prostatectomy?
P
Population
20 consecutive patients scheduled for radical retropubic prostatectomy
I
Intervention
Epidural anesthesia (EA)
C
Comparator
General anesthesia (GA)
O
Outcome
Cardiac sympathovagal balance (ratio of low (0.05-0.125 Hz)/high (0.125-0.5 Hz) frequency power on ECG) and peripheral vasoconstriction (forearm minus fingertip skin-surface temperature gradient > 4 degrees C)surrogate
Epidural anesthesia is associated with a significant intraoperative shift in cardiac sympathovagal balance toward sympathetic predominance compared to general anesthesia.
Cite This Study
Fleisher et al. (1994) studied this question.