The Cardiovascular Effects of Thoracic Bolus Epidural Injection of Lidocaine, Morphine and Fentanyl during Sevoflurane General Anesthesia

Background: Thoracic epidural anesthesia (TEA) combined with general anesthesia is commonly used in major upper abdominal surgery. The advantages of this method is the suppression of the perioperative stress response, the improvement in endocardial perfusion, and the reduction of myocardial oxygen consumption, postoperative morbidity and mortality. In particular, this method reduces the level of postoperative ileus and intestinal anastomosis leakage during gastrointestinal surgery. However, there is the possibility of severe cardiovascular depression using this combination method. This study evaluates the cardiovascular effects of extensive TEA combined with sevoflurane general anesthesia.Methods: Fifty patients scheduled subtotal gastrectomy were enrolled in this study. After administering a bolus injection of 20 ml of 0.375% ropivacaine through an epidural catheter during sevoflurane general anesthesia, mean arterial pressure, heart rate, stroke volume, cardiac output, and systemic vascular resistance measured by Hemosonic (HemoSonic TM 100, Arrow, USA) every 5 minutes over a 30-minute period after the injection.Results: All the data showed a significant decrease from 5 minutes after the epidural bolus injection except for the stroke volume, but that was not important clinically.Conclusions: A thoracic epidural injection of 20 ml of 0.375% ropivacaine can be used safely during sevoflurane anesthesia without severe cardiovascular complications during upper abdominal surgery.

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The Cardiovascular Effects of Thoracic Epidural Injection of Ropivacaine during Sevoflurane General Anesthesia

Yoo

Choi

et al. 2007

Korean J Anesthesiol

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The Cardiovascular Effects of Thoracic Bolus Epidural Injection of Lidocaine, Morphine and Fentanyl during Sevoflurane General Anesthesia

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The Cardiovascular Effects of Thoracic Epidural Injection of Ropivacaine during Sevoflurane General Anesthesia

The Cardiovascular Effects of Thoracic Epidural Injection of Ropivacaine during Sevoflurane General Anesthesia

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