Towards pain free cardiac surgery - High thoracic epidural analgesia

Abstract

Epidural analgesia is a well-established analgesic technique, providing complete or near complete perioperative analgesia for major surgery. Epidural analgesia may also confer additional benefits during the perioperative period, including attenuation of the stress response, reduction in procoagulation tendency, and reduction in myocardial ischaemia and infective complications. These additional benefits are an advantage in patients with ischaemic heart disease. We discuss the use of high thoracic epidural anaesthesia in cardiac surgery, outlining potential benefits and risks. Our experience with epidural analgesia in over 300 patients undergoing cardiac surgery is briefly described.