Impact of high thoracic epidural anesthesia on incidence of perioperative atrial fibrillation in off-pump coronary bypass grafting: A prospective randomized study

Bakhtiary, Farhad; Therapidis, Panagiotis; Dzemali, Omer; Ak, Koray; Ackermann, Hanns; Meininger, Dirk; Kessler, Paul; Kleine, Peter; Moritz, Anton; Aybek, Tayfun; Doğan, Selami

doi:10.1016/j.jtcvs.2007.03.043

Cited by 51 publications

(31 citation statements)

References 20 publications

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“…Significant difference was found in PaO2 and PaCO2 half an hour after extubation, 1st Post-operative day and 2nd Postoperative day. These findings were closely resembles the findings of Bakhtiary et al and Tenling et al 7,10 Post operative hospital stay in days in both groups of patients was observed. There was statistically significant differences in respect to hospital stay in days between groups.…”

Section: Discussionsupporting

confidence: 91%

“…Furthermore improved post-operative pulmonary function, additionally post-operative pain management is facilitated by continuous epidural application of analgesia; such effective pain management improves early post-operative mobilization & recovery. 7 The epidural analgesia is an important adjunct to immediate extubation because the intraoperative anesthesia requirements are less and analgesia optimized. The potential benefits of early extubation include cost savings, lowered nursing dependency, reduced airway and lung trauma, improved cardiac output and renal perfusion with spontaneous respiration.…”

Section: Evaluation Of Pulmonary Function After Offpump Coronary Artementioning

confidence: 99%

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Evaluation of Pulmonary Function after Off- Pump Coronary Artery Bypass Graft Surgery with Thoracic Epidural Analgesia.

et al. 2013

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Introduction:Coronary artery disease is the most common form of heart disease and the single most important cause of premature death in the developed world. 1 Surgical management of Ischaemic heart disease (IHD) is coronary artery bypass graft surgery (CABG), which can be performed either under cardiopulmonary bypass (CPB) or by using offpump technique. Impairment of pulmonary function after CABG is one of the most common complications in the early post-operative period. 2 Sternotomy, pleurotomy with opening of the pleural space, harvesting of internal mammary artery and pain may lead to deterioration of postoperative pulmonary function. In addition, the incidence of concurrent chronic lung disease is higher in the age group of patients who require revascularization of the myocardium. Combined these two factors indicate a need for documentation of pulmonary function pre-and postoperatively. .3Coronary revascularization procedure is done usually through median sternotomy incision and for this; impairment of pulmonary function is one of the most significant post-operative complication of CABG. 4 For revascularization, emphasis is given over internal mammary artery (IMA) graft. The mediastinum and thoracic cavity are traumatized more with IMA than with reverse saphenous

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Section: Discussionsupporting

confidence: 91%

Section: Evaluation Of Pulmonary Function After Offpump Coronary Artementioning

confidence: 99%

Evaluation of Pulmonary Function after Off- Pump Coronary Artery Bypass Graft Surgery with Thoracic Epidural Analgesia.

et al. 2013

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“…Other studies also support this result. 7,10 There were 18 patients (60%) who had history of smoking, 12 patients were hypertensive, 6 patients are diabetes, three had family history of IHD and three patients had Dyslipidaemia and 8 patients had history of old MI in group-A whereas in group-B only 15 patients (50%) were smoker, 12 patients (33.33%) were hypertensive, 9 patients (30%) were diabetic, 3 patients (10%) were dyslipidaemic, 6 patients (20%) had family history and 7 patients were Old MI. The mean value of total ICU stays in hours in Group-A was 43.4±3.0 and in Group-B was 52.9±5.0 hours.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore improved post-operative pulmonary function, additionally post-operative pain management is facilitated by continuous epidural application of analgesia; such effective pain management improves early post-operative mobilization & recovery. 7 TEA decreases the post-operative hormonal stress response and improves cardiac & respiratory function. The epidural analgesia is an important adjunct to immediate extubation because the intraoperative anesthesia requirements are less and analgesia optimized.…”

mentioning

confidence: 97%

Early Post operative Pain Management and Early Extubation after Off-pump Coronary Artery Bypass Graft Surgery is better managed with Thoracic Epidural Analgesia

et al. 2017

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Introduction:Coronary artery disease is the most common form of heart disease and the single most important cause of premature death in the developed world. 1 Surgical management of IHD is coronary artery bypass graft surgery (CABG), which can be performed either under cardiopulmonary bypass (CPB) or by using off-pump technique. Impairment of pulmonary function after CABG is one of the most common complications in the early postoperative period. 2 Sternotomy, pleurotomy with opening of the pleural space, harvesting of internal mammary artery and pain may lead to deterioration of post-operative pulmonary function. In addition, the incidence of concurrent chronic lung disease is higher in the age group of patients who require revascularization of the myocardium. Combined these two factors indicate a need for documentation of pulmonary function pre-and postoperatively. 3 Coronary revascularization procedure is done usually through median sternotomy incision and for this; impairment of pulmonary function is one of the most significant post-operative complications of CABG. 4 For revascularization, emphasis is given over internal mammary artery (IMA) graft. The mediastinum and thoracic cavity are traumatized more with IMA than with reverse saphenous vein graft (RSVG) procedure. Indeed, some reports have found that IMA patients have worse pulmonary functions than the RSVG patients in the postoperative period. 5 Basal atelectasis develops early during anaesthesia and may persist in the post-operative period. After surgery both respiratory muscles

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“…[17] of pump koroner arter baypas cerrahisinde genel anestezinin yanı sıra torakal epidural anestezi uygulamasının endojen epinefrin düzeylerini düşürdüğünü ve intraoperatif AF ve aritmi gelişimini azaltığını görmüşlerdir.…”

Section: Atriyal Fibrilasyonu Olan Hastalarda Anestezi Ve Cerrahi Ileunclassified

Anesteziyolog Bakış Açısından Atriyal Fibrilasyon

Kabukçu¹,

Şahin²,

Titiz³

2017

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ÖZ GiRiŞAtriyal fibrilasyon (AF) en sık görülen kardiyak aritmidir, atriyal miyositlerdeki elektiriksel aktivitenin bozukluğu ile oluşur. AF serebral tromboemboli zemininde inme ve diğer tromboembolik olaylar, sol ventrikül fonksiyon bozukluğu, kalp yetmezliği gibi mortaliteyi artıran ciddi komplikasyonlar ile birliktedir. Ayrıca hastaneye yatış oranında artma, yaşam kalitesinin bozulması ve egzersiz kapasitesinin azalması gibi nedenlerle morbiditeyi etkilemektedir [1] . AF genel popülasyonun %1-2'sinde ve görülme sıklığı 40-50 yaş aralığındadır. Yaşla birlikte artmakta ve 80 yaşında % 5-15 oranına ulaşmaktadır [2][3][4][5][6] . Erkekler kadınlardan daha fazla etkilenmektedir [7] .EKG'de P dalgalarının yokluğu ve düzensiz RR aralı-ğı saptanması ile AF tanısı konur. Aritminin başlangıç ve seyrine göre paroksismal, ısrarcı ve kalıcı olmak üzere üç sekilde sınıflandırılır. Paroksismal AF 48 saat içinde genellikle kendiliğinden düzelir. Israrcı AF 1 haftadan 1 yıla kadar sürebilir, kendiliğinden düzelmez medikal veya doğru akım (DC) kardiyoversiyon ile sinüs ritmine döndürülebilir (Tablo 1). Kalıcı AF'de medikal veya kardiyoversiyon ile sinüs ritmine dönüş olası olmaz [1,8,9] . AF tanısı EKG ile kolaylıkla konmasına rağmen, birçok hastada asemptomatiktir. Komplikasyonlar gelişene kadar tanı konamayabilir. AF nedeni kardiyovasküler veya değildir. Örneğin, geçirilmiş miyokard infarktüsü, kardiyomiyopati, hipertansiyon, kapak hastalıkları ve kalp yetmezliği kardiyovasküler nedenlerdir. Diyabet, obezite, alkol, hipertiroidi, KOAH ve diğer metabolik bozukluklar ise diğer AF nedenleridir [8,10] .Preoperatif AF tanısı alan hastada anestezist, semptomları hafifletme, hemodinamik stabiliteyi devam ettirme ve kardiyopulmoner komplikasyonları önle-meye odaklanmalıdır. Cerrah ile birlikte anestezist, cerrahiye devam kararına varmadan önce kalp açısın-dan temel laboratuvar ve görüntüleme tetkiklerinin gerekliliğine karar vermelidir [1,11] .

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Impact of high thoracic epidural anesthesia on incidence of perioperative atrial fibrillation in off-pump coronary bypass grafting: A prospective randomized study

Cited by 51 publications

References 20 publications

Evaluation of Pulmonary Function after Off- Pump Coronary Artery Bypass Graft Surgery with Thoracic Epidural Analgesia.

Evaluation of Pulmonary Function after Off- Pump Coronary Artery Bypass Graft Surgery with Thoracic Epidural Analgesia.

Early Post operative Pain Management and Early Extubation after Off-pump Coronary Artery Bypass Graft Surgery is better managed with Thoracic Epidural Analgesia

Anesteziyolog Bakış Açısından Atriyal Fibrilasyon

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