Epidural anesthesia and analgesia: effects on recovery from cardiac surgery.
OBJECTIVE
To measure predefined clinical effects resulting from the use of epidural anesthesia and analgesia during and after cardiac surgery.


METHODS
Prospective, randomized, nonblinded clinical trial.


METHODS
Single academic medical center.


METHODS
Sixty patients scheduled for elective cardiac surgery with cardiopulmonary bypass.


METHODS
Sixty participants were randomly assigned to 1 of 2 study groups: (1) A control group received general anesthesia during surgery and intravenous opiate analgesia after surgery. (2) A treatment group received thoracic epidural anesthesia combined with general anesthesia during surgery and epidural analgesia for the first 24 postoperative hours.


RESULTS
Primary study measurements were planned to evaluate recovery from surgery and included time to tracheal extubation, duration of postoperative intensive care unit stay, duration of postoperative hospitalization, pain control, urinary free cortisol, cardiopulmonary complication rate, and total hospital charges. No statistically significant differences between the 2 study groups were found in these main measurements.


CONCLUSIONS
The clinical course of elective cardiac surgical patients who receive epidural anesthesia during surgery and epidural analgesia after surgery is comparable to that of patients managed with general anesthesia alone during surgery followed by parenteral opiate analgesia after surgery.
Fillinger
Mary P
MP
Departments of Anesthesiology and Surgery, Dartmouth-Hitchcock Medical Center, Lebanon; and Dartmouth Medical School, Hanover, NH 03756, USA. Mary.P.Fillinger@Hitchcock.ORG
Yeager
Mark P
MP
Dodds
Thomas M
TM
Fillinger
Mark F
MF
Whalen
P Kate
PK
Glass
D David
DD
D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007275:Injections, Intravenous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications; D011446:Prospective Studies
D000701:Analgesics, Opioid; D009020:Morphine