A prospective randomized study of the post-operative outcomes of thoracic epidural analgesia in patients undergoing coronary artery bypass graft surgery

To assess the efficacy of thoracic epidural analgesia (TEA) for postoperative pain and effect on haemodynamics, pulmonary functions postoperatively in patients undergoing coronary artery bypass graft (CABG). : Ninety patients posted for elective CABG were randomly allocated using sealed envelope method into two groups, Group A received injection fentanyl for intraoperative analgesia and injection tramadol for postoperative analgesia intravenously and Group B received 10 ml of 0.5% ropivacaine with 50 µg fentanyl as bolus dose epidurally and thereafter, continuous epidural infusion of 0.2% ropivacaine with 2µg/ml fentanyl at the rate of 8ml/h till the end of surgery for intraoperative analgesia and then 6-10ml/h till 48h for postoperative analgesia. All patients were given general anaesthesia. Haemodynamics, arterial blood gases, visual analog scale (VAS) score and peak expiratory flow rate (PEFR) were reported in ICU till 48h postoperatively. Statistical analysis used: unpaired - test and Chi-square test. Group B showed significantly lesser VAS score, higher PEFR, higher PaO2 and normal values of PaCO2. TEA reduces postoperative pain and improves postoperative pulmonary function in patients undergoing CABG. Also, it is associated with earlier extubation and a wakening, stable haemodynamics and lesser ICU stay after CABG surgery.