Thoracic Epidural Anesthesia Improves Early Outcome in Patients Undergoing Cardiac Surgery for Mitral Regurgitation: A Propensity-Matched Study

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• 作者：Fabrizio Monaco ; MD ; Camilla Biselli ; MD ; Giovanni Landoni ; MD ; ^{landoni.giovanni@hsr.it} ; Monica De Luca ; MD ; Rosalba Lembo ; MS ; Remo Daniel Covello ; MD ; Alberto Zangrillo ; MD
• 关键词：epidural ; cardiac surgery ; mitral surgery ; anesthesia ; intensive care ; thoracic epidural anesthesia
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：2013
• 出版时间：June, 2013
• 年：2013
• 卷：27
• 期：3
• 页码：445-450
• 全文大小：235 K

文摘

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ass=""h4"">Objective

There are no large studies that investigate the effect of thoracic epidural anesthesia (TEA) combined with general anesthesia (GA) in patients undergoing valvular surgery. The authors hypothesized that TEA might improve clinically relevant endpoints in patients with primary mitral regurgitation.

ass=""h4"">Design

Propensity-matched study.

ass=""h4"">Setting

Cardiac surgery.

ass=""h4"">Participants

Patients scheduled for mitral valve repair or replacement were studied.

ass=""h4"">Interventions

A propensity model was constructed to match 33 patients receiving TEA combined with GA with 33 patients receiving standard GA alone.

ass=""h4"">Measurements and Main Results

Overall, the TEA group suffered fewer adverse events than the GA group: 10 (30 % ) v 23 (10 % ) with p = 0.002. In particular, the TEA group had a lower incidence of pulmonary events, 6 (18 % ) v 15 (45 % ) with p = 0.02, and of cardiac events, 8 (24 % ) v 16 (49 % ) with p = 0.04. Median (interquartile) time on mechanical ventilation was reduced in the TEA group, 11 (9-15) v 17 (12-36) with p = 0.007.

ass=""h4"">Conclusions

This propensity-matched study suggested that TEA might be advantageous in patients undergoing surgery for mitral regurgitation.