title: High thoracic epidural analgesia for cardiac surgery: an audit of 874 cases.
abstract: Despite clinical use for over 10 years, high thoracic epidural analgesia for cardiac surgery remains controversial, due to a perceived increased risk of epidural haematoma resulting from anticoagulation for cardiac pulmonary bypass. There are no sufficiently large randomised studies to address this question and few large case series reported. For this reason, we conducted an audit of neurological complications related to high thoracic epidural analgesia during cardiac surgery in our institution between 1998 and end 2005. During this period 874 patients received epidural analgesia. There were no neurological complications attributable to epidural use. Our findings suggest that major neurological complications related to high thoracic epidural use during cardiac surgery are rare.
authors.affiliation: Department of Anaesthesia and Pain Medicine, Royal Melbourne Hospital, Carlton, Victoria, Australia.
authors.forename: C F
authors.initials: CF
authors.lastname: Royse
authors.forename: P F
authors.initials: PF
authors.lastname: Soeding
authors.forename: A G
authors.initials: AG
authors.lastname: Royse
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D000925:Anticoagulants / Q000008:administration & dosage; D006348:Cardiac Surgical Procedures; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000209:etiology; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D000925:Anticoagulants; D006493:Heparin