Why the study?
Despite evident benefits of high thoracic epidural anesthesia in CABG, restrictions exist due to the risk of epidural hematoma with neurological consequences, motivating a review of its physiological effects and clinical aspects.
Does high thoracic epidural anesthesia improve outcomes and reduce perioperative stress in patients undergoing coronary artery bypass grafting?
Does high thoracic epidural anesthesia improve outcomes and reduce perioperative stress in patients undergoing coronary artery bypass grafting?
Answers are grounded in this paper and cite their sources.
High thoracic epidural anesthesia in CABG offers benefits in reducing perioperative stress and pain, but carries a significant risk of epidural hematoma.
The cardiovascular diseases have top-rated place amongst causes of death all around the world. The leading cardiovascular pathology is coronary artery disease; its course is dependent on severity of atherosclerotic lesion of coronary vessels. Coronary artery bypass grafting (CABG) is one from the most often performed medical techniques of coronary revascularization but has a high risk of perioperative respiratory complications, myocardial infarction, dysrhythmias, kidney dysfunction and other problems. High thoracic epidural anesthesia (HTEA) and analgesia provides sympathetic nerve block of cardiac dermatomes, decreases perioperative stress and pain after CABG, and has a protective role regarding cardiac and respiratory functions. These effects of HTEA are confirmed by a number of studies and systematic reviews. Apart from evident benefits of HTEA, there are restrictions for its use in cardiac surgery associated with increased risk of epidural hematoma followed by neurological consequences. In our review, we describe physiological effects and clinical aspects of using HTEA in coronary surgery.
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Volkov et al. (2020) studied this question.
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