Cargando…

The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery

BACKGROUND: Thoracic epidural anesthesia (TEA) improves analgesia and outcomes after a cardiac surgery. As aging is a risk factor for postoperative pulmonary complications, TEA is of particular importance in elderly patients undergoing coronary artery bypass graft (CABG). METHODS: Fifty patients age...

Descripción completa

Detalles Bibliográficos
Autores principales: El-Morsy, Gamal Z., El-Deeb, Alaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299108/
https://www.ncbi.nlm.nih.gov/pubmed/22412771
http://dx.doi.org/10.4103/1658-354X.93048
_version_ 1782226068661338112
author El-Morsy, Gamal Z.
El-Deeb, Alaa
author_facet El-Morsy, Gamal Z.
El-Deeb, Alaa
author_sort El-Morsy, Gamal Z.
collection PubMed
description BACKGROUND: Thoracic epidural anesthesia (TEA) improves analgesia and outcomes after a cardiac surgery. As aging is a risk factor for postoperative pulmonary complications, TEA is of particular importance in elderly patients undergoing coronary artery bypass graft (CABG). METHODS: Fifty patients aged 65–75 years; ASA II and III scheduled for elective CABG were included in the study. Patients were randomized to receive either general anesthesia (GA) group alone or GA combined with TEA group. Heart rate (HR), mean arterial pressure (MAP), and central venous pressure were recorded. Total dose of fentanyl μg/kg, aortic cross clamping, cardiopulmonary bypass (CPB) time, time to first awaking and extubation, arterial blood gases, visual analog scale (VAS) score in intensive care unit were reported. Postoperative pulmonary function tests were done. RESULTS: TEA showed a significant HR and lower MAP compared with the GA group. The total dose of intraoperative fentanyl and nitroglycerine were significantly lower in the TEA. Patients in TEA group have statistically significantly higher PaO(2), lower PaCO(2), increase in Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV(1)) CONCLUSIONS: TEA reduced severity of postoperative pulmonary function and restoration was faster in TEA group in elderly patients undergoing CABG. Also, it resulted in earlier extubation and awakening, better analgesia, lower VAS.
format Online
Article
Text
id pubmed-3299108
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-32991082012-03-12 The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery El-Morsy, Gamal Z. El-Deeb, Alaa Saudi J Anaesth Original Article BACKGROUND: Thoracic epidural anesthesia (TEA) improves analgesia and outcomes after a cardiac surgery. As aging is a risk factor for postoperative pulmonary complications, TEA is of particular importance in elderly patients undergoing coronary artery bypass graft (CABG). METHODS: Fifty patients aged 65–75 years; ASA II and III scheduled for elective CABG were included in the study. Patients were randomized to receive either general anesthesia (GA) group alone or GA combined with TEA group. Heart rate (HR), mean arterial pressure (MAP), and central venous pressure were recorded. Total dose of fentanyl μg/kg, aortic cross clamping, cardiopulmonary bypass (CPB) time, time to first awaking and extubation, arterial blood gases, visual analog scale (VAS) score in intensive care unit were reported. Postoperative pulmonary function tests were done. RESULTS: TEA showed a significant HR and lower MAP compared with the GA group. The total dose of intraoperative fentanyl and nitroglycerine were significantly lower in the TEA. Patients in TEA group have statistically significantly higher PaO(2), lower PaCO(2), increase in Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV(1)) CONCLUSIONS: TEA reduced severity of postoperative pulmonary function and restoration was faster in TEA group in elderly patients undergoing CABG. Also, it resulted in earlier extubation and awakening, better analgesia, lower VAS. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3299108/ /pubmed/22412771 http://dx.doi.org/10.4103/1658-354X.93048 Text en Copyright: © Saudi Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
El-Morsy, Gamal Z.
El-Deeb, Alaa
The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
title The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
title_full The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
title_fullStr The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
title_full_unstemmed The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
title_short The outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
title_sort outcome of thoracic epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299108/
https://www.ncbi.nlm.nih.gov/pubmed/22412771
http://dx.doi.org/10.4103/1658-354X.93048
work_keys_str_mv AT elmorsygamalz theoutcomeofthoracicepiduralanesthesiainelderlypatientsundergoingcoronaryarterybypassgraftsurgery
AT eldeebalaa theoutcomeofthoracicepiduralanesthesiainelderlypatientsundergoingcoronaryarterybypassgraftsurgery
AT elmorsygamalz outcomeofthoracicepiduralanesthesiainelderlypatientsundergoingcoronaryarterybypassgraftsurgery
AT eldeebalaa outcomeofthoracicepiduralanesthesiainelderlypatientsundergoingcoronaryarterybypassgraftsurgery