title: [Efficacy of epidural analgesia in minimally invasive direct coronary artery bypass surgery].
abstract: Minimally invasive direct coronary artery bypass surgery (MIDCAB), coronary bypass grafting with small thoracotomy using no cardiopulmonary bypass (CPB), became popular recently. To attenuate perioperative stress-response, we used epidural analgesia (EPI) with general anesthesia for MIDCAB operation. In this study, we compared retrospectively 11 cases of MIDCAB managed with EPI [ED (+)], and 14 cases of MIDCAB anesthetized without using EPI [ED (-)], concerning extubation time, ICU stay, hospital stay and perioperative complications. The mean time from cessation of general anesthesia to extubation was significantly shorter in ED (+) patients (0.5 hours) when compared to ED (-) patients (18.2 hours). Mean periods of ICU stay and hospital stay were, also, shorter in ED (+) patients (2.1 days, 30.5 days, respectively) when compared to ED (-) (4.3 days, 45.1 days, respectively) patients. We experienced ventricular tachycardia in three patients of ED (-). No major complication occurred in ED (+) patients. These results suggest that EPI shortened extubation time, ICU and hospital stay for MIDCAB patients.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Toyama Medical and Pharmaceutical University.
authors.forename: M
authors.initials: M
authors.lastname: Wakasugi
authors.forename: K
authors.initials: K
authors.lastname: Shakunaga
authors.forename: J
authors.initials: J
authors.lastname: Fujimura
authors.forename: K
authors.initials: K
authors.lastname: Jomura
authors.forename: A
authors.initials: A
authors.lastname: Masuda
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
mesh_terms: D000368:Aged; D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013908:Thoracotomy