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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2012
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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 |
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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 |
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