The Effects of Thoracic Epidural Analgesia on Postoperative Pain and Myocardial Protection in Coronary Artery Bypass Surgery

Aim: Thoracic epidural analgesia (TEA) in cardiac surgery provides\udstable hemodynamics and postoperative analgesia by reducing\udstress response. The aim of this study was to investigate the effects\udof TEA in coronary artery bypass grafting (CABG) on postoperative\udpain, myocardial protection, intensive care unit (ICU) and hospital\udlength of stay.\udMethods: After receiving approval from the hospital scientific\udcommittee and obtaining written informed consent from the\udparticipants, 40 patients, who were undergoing elective CABG,\udwere included in the study. The patients were prospectively\udrandomized into two groups as TEA group (n=20) and control\udgroup (n=20). Epidural catheters were placed one day before\udsurgery at the T5-T6 level, levobupivacaine 2 µg/mL and fentanyl 5\udmL/hr infusions were initiated in the ICU. Control group received\udintravenous infusion of fentanyl 8 µg/kg/hr. Infusions continued\udfor 24 hours in both groups.\udResults: Time to extubation was shorter, postoperative hypertension\udwas less frequent and pain scores were lower in TEA group than in\udcontrol group (p<0.01). There was no difference in length of stay in\udthe ICU, CK-MB and troponin I levels between the groups, however,\udlength of hospital stay was shorter in TEA group.\udConclusion: TEA with levobupivakain in CABG was found to\udprovide stable hemodynamics, effective analgesia and to shorten\udlength of hospital stay. (The Medical Bulletin of Haseki 2015; 53:\ud72-6