HIGH VERSUS LOW THORACIC EPIDURAL ANALGESIA IN ISCHAEMIC PATIENTS UNDERGOING MAJOR ABDOMINAL SURGERY:EFFECT ON POSTOPERATIVE CARDIAC OUTCOME

Abstract

Previous studies m non cardiac surgical populations have demonstrated that blockade of the sympathetic nervous system results in a decrease of myocardial ischaemic and infarction (Mangano et al. 1996).

Selective blockade of cardiac syr7pathetic innervation (TI-TS) can easily be achieved by administration of local anesthetics through an epidural catheter in the upper thoracic region (Saada eta!. 1992).

The aim of the present work was to study the effect of high thoracic epidural analgesia on postoperative cardiac morbidity in non cardiac patients with preexisting CAD.

Thirty adults patients, aged 40-60 years old were recruited into the study, they were electively scheduled 'to undergoing major abdominal surgery.

Excluded from the study were patients who refused to participate into the trial or to have TEA and those with any contraindications to the regional technique used.

The included patients were allocated randomly into two groups to receive either high thoracic epidural (n = 15) or low thoracic epidural (n = 15). The epidural technique empfoyed in both groups was used for intraoperative anesthesia, combined with general one and for postoperative analgesia.