Epidural Anesthesia and Pain Relief in Heart Surgery
Author Information
Author(s): Kirov Mikhail Y, Eremeev Alexey V, Smetkin Alexey A, Bjertnaes Lars J
Primary Institution: Northern State Medical University
Hypothesis
After OPCAB, thoracic epidural analgesia with ropivacaine and fentanyl aiming at a visual analog scale (VAS) score < 30 mm will be associated with improved cardiopulmonary parameters in comparison with intravenously administered analgesia.
Conclusion
Epidural anesthesia with ropivacaine/fentanyl improves lung function and reduces the duration of mechanical ventilation after heart surgery.
Supporting Evidence
- Epidural anesthesia reduced the need for intravenous fentanyl by 50%.
- PCEA decreased the duration of mechanical ventilation by 32% compared to the control group.
- EA improved lung function and myocardial performance during surgery.
Takeaway
This study shows that using a special type of pain relief during heart surgery helps patients breathe better and get off the breathing machine faster.
Methodology
93 patients were randomized into three groups: control (IV fentanyl), epidural infusion (EA), and patient-controlled epidural analgesia (PCEA) with ropivacaine/fentanyl.
Potential Biases
Potential bias in patient selection and the subjective nature of pain assessment.
Limitations
The study's findings may not be generalizable due to the specific patient population and the small sample size in each group.
Participant Demographics
Adult patients with coronary artery disease, ASA III, scheduled for elective OPCAB.
Statistical Information
P-Value
0.04
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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