Why the study?
Inadequate postoperative analgesia can increase morbidity through adverse hemodynamic and metabolic changes and prolong mechanical ventilation and ICU stay, prompting comparison of high thoracic epidural anesthesia with general anesthesia versus general anesthesia alone in OPCAB.
Does high thoracic epidural anaesthesia combined with general anaesthesia reduce postoperative pain and rescue analgesic requirement compared to general anaesthesia alone in patients undergoing off-pump coronary artery bypass surgery?
Does high thoracic epidural anaesthesia combined with general anaesthesia reduce postoperative pain and rescue analgesic requirement compared to general anaesthesia alone in patients undergoing off-pump coronary artery bypass surgery?
High thoracic epidural anaesthesia combined with general anaesthesia significantly reduces postoperative pain and the need for rescue analgesics compared to general anaesthesia alone in patients undergoing off-pump CABG.
Supports combined high thoracic epidural-general anesthesia to reduce rescue analgesics after off-pump CABG; confirms RCT benefit and extends regional technique evidence.
Background: In the postoperative period inadequate analgesia may increase morbidity by causing adverse haemodynamic, metabolic, immunologic and haemostatic attentions and prolong mechanical ventilation with more ICU stay. This study has been undertaken to compare postoperative outcome in off-pump coronary artery bypass surgery (OPCAB) between high thoracic epidural anaesthesia (HTEA) as an adjunct to general anaesthesia (GA) vs. GA alone. Methods : This prospective, randomized case control comparative study was carried out in sixty patients without having left main coronary artery disease, left ventricular ejection fraction <30% or contraindication of regional anaesthesia scheduled for OPCAB. They were divided into two groups, thirty in each group. Group A received GA alone and group B received high thoracic epidural anaesthesia with GA. Requirement of postoperative analgesics, pain score, sedation score, and post-operative complications were evaluated. Results: Rescue analgesics was needed in 16 (53.3%) and 6 (20.0%) patients in group A and group B respectively (p<0.05). Post-operative pain score (VAS) during maintenance with ventilator with awareness at first fourth hour and after extubation during movement & cough were significantly different between two groups. Post-operative sedation score was significantly different between two groups except in 1st hour. No post-operative complication was observed in both groups. Conclusion: High thoracic epidural anaesthesia with GA appeared to be most reliable postoperative pain reliever with better post-operative outcome in OPCAB surgery. Cardiovasc j 2022; 15(1): 63-68
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Azad et al. (2022) studied this question.
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