Key result
Thoracic epidural blockade with 0.5% bupivacaine added to general anaesthesia did not prevent the postoperative hypercoagulability response following abdominal aortic bypass surgery.
Why the study?
Does general anaesthesia plus thoracic epidural blockade with 0.5% bupivacaine prevent postoperative hypercoagulability in patients undergoing elective abdominal aortic bypass surgery?
RCT (n=20)
randomised
Does general anaesthesia plus thoracic epidural blockade with 0.5% bupivacaine prevent postoperative hypercoagulability in patients undergoing elective abdominal aortic bypass surgery?
The addition of thoracic epidural blockade to general anesthesia does not prevent postoperative hypercoagulability in patients undergoing abdominal aortic bypass surgery.
Answers are grounded in this paper and cite their sources.
Thoracic epidural adds no protection against hypercoagulability after aortic bypass; challenges assumptions of its antithrombotic effect and redirects research to alternative strategies.
The effect of epidural blockade on postoperative hypercoagulability was assessed in patients undergoing elective abdominal aortic bypass surgery. Twenty patients were randomised to receive general anaesthesia alone, or general anaesthesia plus thoracic epidural blockade with 0.5% bupivacaine. It was found that the addition of epidural blockade did not alter the postoperative increase in plasma fibrinogen, factor VIII coagulant, or alpha 1-antitrypsin. Similarly, epidural blockade did not affect the postoperative decrease in antithrombin III. The results suggest that epidural blockade with local anaesthetic agents does not prevent the postoperative hypercoagulability response following abdominal aortic bypass surgery.
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Gibbs et al. (1992) conducted an RCT in elective abdominal aortic bypass surgery (n=20). Thoracic epidural blockade vs. General anaesthesia alone was evaluated on Postoperative hypercoagulability (plasma fibrinogen, factor VIII coagulant, alpha 1-antitrypsin, antithrombin III). Thoracic epidural blockade with 0.5% bupivacaine added to general anaesthesia did not prevent the postoperative hypercoagulability response following abdominal aortic bypass surgery.
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