High thoracic epidural blockade increases myocardial oxygen availability in coronary surgery patients

Acta Anaesthesiologica Scandinavica

Volumn 50, Issue 7, 2006, Pages 780-786

  Lagunilla, J ^a   Garcia Bengochea J B ^b   Fernandez A L ^b,c   Alvarez, J ^a   Rubio, J ^b   Rodriguez J ^a   Veiras, S ^a  

^a UNIVERSITY OF SANTIAGO DE COMPOSTELA   (Spain)

^b HOSPITAL CLÍNICO UNIVERSITARIO   (Spain)

^c Pediatric Nutrition Research Group Health Research Institute of Santiago de Compostela   (Spain)

Author keywords

Anesthesia; Coronary surgery; High thoracic epidural; Intramyocardial partial oxygen pressure

Indexed keywords

ROPIVACAINE; SODIUM CHLORIDE;

ADULT; AGED; ARTICLE; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; DEMOGRAPHY; DOUBLE BLIND PROCEDURE; DRUG EFFECT; EPIDURAL CATHETER; EPIDURAL SPACE; FEMALE; GENERAL ANESTHESIA; HEART MUSCLE OXYGEN CONSUMPTION; HEART MUSCLE REVASCULARIZATION; HEMODYNAMIC PARAMETERS; HUMAN; MALE; OXYGEN TENSION; OXYGEN TISSUE LEVEL; PATIENT MONITORING; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; THORACIC SPINE; THORAX EPIDURAL ANESTHESIA;

AGED; AMIDES; ANALGESIA, EPIDURAL; ANESTHESIA, EPIDURAL; ANESTHETICS, LOCAL; CORONARY ARTERY BYPASS; DOUBLE-BLIND METHOD; FEMALE; HUMANS; MALE; MIDDLE AGED; MYOCARDIUM; OXYGEN; PARTIAL PRESSURE;

EID: 33745882384     PISSN: 00015172     EISSN: 13996576     Source Type: Journal    
DOI: 10.1111/j.1399-6576.2006.01059.x     Document Type: Article

References (26)

1. Goldstein S, Dean D, Kim SJ et al. A survey of spinal and epidural techniques in adult cardiac surgery. J Cardiothorac Vasc Anesth 2001; 15 (2): 158-68.
2. Royse CD, Royse A, Soeding P et al. Prospective randomized trial of high thoracic epidural analgesia for coronary artery bypass surgery. Ann Thorac Surg 2003; 75: 93-100.
3. Tenling A, Joachimsson PO, Tyden H et al. Thoracic epidural anesthesia as an adjunct to general anesthesia for cardiac surgery: effects on ventilation-perfusion relationships. Acta Anaesthesiol Scand 2000; 44: 1071-6.
4. Davis RF, de Boer LWV, Maroko PR. Thoracic epidural anesthesia reduces myocardial infarct size after coronary artery occlusion in dogs. Anesth Analg 1986; 65: 711-7.
5. Hogan QH, Novalija E, Kulier AH et al. Effect of thoracic epidural anesthesia on spontaneous postinfarction ventricular dysrhythmia in awake dogs. Reg Anesth 1997; 22: 318-24.
6. Rolf N, Meissner A, van Aken H et al. Thoracic epidural anesthesia improves functional recovery from myocardial stunning in conscious dogs. Anesth Analg 1996; 83: 935-40.
7. Blomberg S, Ricksten SE. Thoracic epidural anaesthesia decreases the incidence of ventricular arrhythmias during acute myocardial ischaemia in the anaesthetized rat. Acta Anaesthesiol Scand 1988; 32: 173-8.
8. Meissner A, Eckardt L, Kirchhof P et al. Effects of thoracic epidural anesthesia with and without autonomic nervous system blockade on cardiac monophasic action potentials and effective refractoriness in awake dogs. Anesthesiology 2001; 95: 132-8.
9. Kock M, Blomberg S, Emmanuelson H et al. Thoracic epidural anesthesia improves global and regional left ventricular function during stress-induced myocardial ischemia in patients with coronary artery disease. Anesth Analg 1990; 71: 625-30.
10. Loick HM, Schmidt C, van Aken H et al. High thoracic epidural anesthesia, but not clonidine, attenuates the perioperative stress response via sympatholysis and reduces the release of troponin T in patients undergoing coronary artery bypass grafting. Anesth Analg 1999; 88: 701-9.
11. Boeckstegers P, Trupkovic T, Krieger M et al. Intramyocardial oxygen partial pressure by means of PO2 catheters. Studies in acute myocardial ischemia, reperfusion and during selective ECG-synchronized suction and retroinfusion of coronary veins (SSR). In: Ehrly, AM, Fleckestein, W, Landgraf, H, eds. Clinical Oxygen Pressure Measurement III. Berlin: Blackwell Weberruter Wissenschaft, 1992: 42-7.
12. Wiener L, Feola M, Templeton JY et al. Monitoring tissue oxygenation of the heart after myocardial revascularization. Am J Cardiol 1976; 38: 38-45.
13. Misfeld M, Rhau JU, Sievers HH et al. Intramyocardial partial oxygen pressure in patients undergoing transmyocardial laser revascularization and bypass surgery. Scand Cardiovasc J 2003; 37: 270-4.
14. Van den Brink WA, van Santbrink H, Steyerberg EW et al. Brain oxygen tension in severe head injury. Neurosurgery 2000; 46: 868-78.
15. Shanewise J, Cheung A, Aronson S et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiographic examination: recommendations of the American Society of Echocardiography Council for intraoperative echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for the certification in perioperative transesophageal echocardiography. J Am Soc Echocardiogr 1999; 12: 884-900.
16. 2 in individual cardiac myocytes in dogs, cats, rabbits, ferrets, and rats. Am J Physiol 1991; 260: H522-31.
17. Wiener L, Santamore W, Templeton JY et al. Monitoring regional myocardial function after myocardial revascularization. J Thorac Cardiovasc Surg 1982; 84: 130-7.
18. Meissner A, Weber TP, van Aken H et al. Limited upper thoracic epidural block and splanchnic perfusion in dogs. Anesth Analg 1999; 89: 1378-81.
19. 2. J Appl Physiol 1990; 68: 833-42.
20. Olausson K, Magnusdottir O, Lurje L et al. Anti-ischemic and anti-anginal effects of thoracic epidural anesthesia versus those of conventional medical therapy in the treatment of severe refractory unstable angina pectoris. Circulation 1997; 96: 2178-82.
21. Blomberg S, Emanuelson H, Kvist H et al. Effects of thoracic epidural anaesthesia on coronary arteries and arterioles in patients with coronary artery disease. Anesthesiology 1990; 73: 840-7.
22. Gould T, Grace K, Thorne G, Thomas M. Effect of thoracic epidural anesthesia on colonie blood flow. Br J Anaesth 2002; 89: 446-51.
23. Hogan QH, Stekiel TA, Stadnicka A, Bosnjak ZJ, Kampine JP. Region of epidural blockade determines sympathetic and mesenteric capacitance effects in rabbits. Anesthesiology 1995; 83: 604-10.
24. Bax JJ, Poldermans D, Visser FC et al. Delayed recovery of hibernating myocardium after surgical revascularization: implications for discrepancy between metabolic imaging and dobutamine echocardiography for assessment of myocardial viability. J Nucl Cardiol 1999; 6: 685-7.
25. Elhendy A, Gelijnse ML, Roeland JR et al. Dobutamine-induced hypoperfusion without transient wall motion abnormalities: less severe ischemia or less severe stress?. J Am Coll Cardiol 1996; 27: 323-9.
26. Ho A, Chung D, Kim SJ et al. Neuraxial blockade and hematoma in cardiac surgery: estimating the risk of rare adverse event that has not (yet) occurred. Chest 2000; 117: 551-5.