High thoracic epidural analgesia reduces the risk of long-term depression in patients undergoing coronary artery bypass surgery.
BACKGROUND
High thoracic epidural analgesia (HTEA) has been shown to reduce psychological morbidity in the early period following coronary artery bypass graft surgery (CABG). Our aim was to identify whether the effect persists in the longer term.


METHODS
Patients from a previous randomised study of HTEA for CABG were followed up 6 months to 3 years following surgery. The cardiac depression scale (CDS) was used to identify severity of depression.


RESULTS
Sixty-one of the original 78 patients were able to participate in the study. Eight point three percent of patients had CDS scores >100, consistent with severe depression (1 epidural patient, 4 control patients, P=0.353). After adjustment for time of follow-up, the CDS scores in patients who received HTEA were significantly lower (66+/-3.5) than patients who received intravenous morphine analgesia (79+/-3.5) P<0.05


CONCLUSIONS
The use of HTEA results in a lower risk of depression 6 months or more following CABG.
Royse
Colin
C
Department of Anaesthesia, The Royal Melbourne Hospital, Melbourne, Australia.
Remedios
Cheryl
C
Royse
Alistair
A
D000368:Aged; D015360:Analgesia, Epidural; D000704:Analysis of Variance; D001026:Coronary Artery Bypass; D003863:Depression / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome