High Thoracic Epidural Analgesia in Cardiac Surgery: Part 1—High Thoracic Epidural Analgesia Improves Cardiac Performance in Cardiac Surgery Patients

Optimal pain management after aortic valve implantation: an opportunity to improve outcomes after transapical access in the future?

“…The question remains if this side effect actually improved peripheral and myocardial perfusion in the TEA group? Results from a randomised study in patients after open cardiac surgery demonstrate that TEA improves cardiac performance by increasing stroke volume index and central venous oxygenation 8. In the study presented myocardial ischaemia was reduced in TEA patients, which may support the hypothesis that myocardial perfusion improved.…”

Remifentanil Compared With Sufentanil Does Not Enhance Fast-Track Possibilities in Cardiac Surgery—A Randomized Study

“…17,18 In the same period SvO 2 decreased, indicating higher oxygen consumption during this period. The lower MAP and higher CVP and mean partial arterial pressure also could have been an indication of a relatively decreased heart function and thus in accordance with Elliott et al, who found that remifentanil deteriorated cardiac function 19 ; a few other studies have found less hemodynamic stability after remifentanil administration compared with other opioids.…”

Evaluation of thoracic epidural analgesia in patients undergoing coronary artery bypass surgery – a prospective randomized trial

“…Despite being applied in cardiac surgery for over 20 years, it is still not in a position to be called a routine procedure for this kind of surgery. Recent literature shows renewed interest in the use of epidurals in cardiac surgery [ 10 , 11 , 18 – 21 ]. The reasons for that are complex and associated with ageing of the population of cardiac surgery patients, which is combined with the increased number of additional risks [ 20 ], especially chronic obstructive respiratory disease [ 22 , 23 ].…”

“…These patients were electively extubated and transferred to the step-down unit for further therapy and rehabilitation, as ST elevation occurs relatively frequently in the early postoperative period and it is most often of no clinical significance [ 40 ]. Most recently, Jakobsen et al [ 18 ] were able to prove that high thoracic epidural analgesia also improves cardiac performance. We were not able to confirm this finding on the basis of the advanced hemodynamic measurements performed in our study.…”