Does High Thoracic Epidural Analgesia with Levobupivacaine Preserve Myocardium? A Prospective Randomized Study

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2015 Apr 29

PMID 25918718

Citations 1

Authors

Serife Gokbulut Bektas

Sema Turan

Umit Karadeniz

Burcin Ozturk

Soner Yavas

Dilan Biricik

Gul Sevim Saydam

Ozcan Erdemli

Affiliations

Soon will be listed here.

Abstract

Background: Our study aimed to compare HTEA and intravenous patient-controlled analgesia (PCA) in patients undergoing coronary bypass graft surgery (CABG), based on haemodynamic parameters and myocardial functions.

Materials And Methods: The study included 34 patients that were scheduled for elective CABG, who were randomly divided into 2 groups. Anesthesia was induced and maintained with total intravenous anesthesia in both groups while intravenous PCA with morphine was administered in Group 1 and infusion of levobupivacaine was administered from the beginning of the anesthesia in Group 2 by thoracic epidural catheter. Blood samples were obtained presurgically, at 6 and 24 hours after surgery for troponin I, creatinine kinase-MB (CK-MB), total antioxidant capacity, and malondialdehyde. Postoperative pain was evaluated every 4 hours until 24 hours via VAS.

Results: There were significant differences in troponin I or CK-MB values between the groups at postsurgery 6 h and 24 h. Heart rate and mean arterial pressure in Group 1 were significantly higher than in Group 2 at all measurements. Cardiac index in Group 2 was significantly higher than in Group 1 at all measurements.

Conclusion: Patients that underwent CABG and received HTEA had better myocardial function and perioperative haemodynamic parameters than those who did not receive HTEA.

Citing Articles

Epidural analgesia for adults undergoing cardiac surgery with or without cardiopulmonary bypass.

Guay J, Kopp S Cochrane Database Syst Rev. 2019; 3:CD006715.

PMID: 30821845 PMC: 6396869. DOI: 10.1002/14651858.CD006715.pub3.

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