Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
https://doi.org/10.21292/2078-5658-2020-17-5-6-14
Abstract
There are certain debates regarding epidural anesthesia (EA) and analgesia in cardiac surgery.
The objective: to evaluate functions of left ventricle (LV) and right ventricle (RV) function with echocardiography after off-pump coronary artery bypass grafting (OPCAB) using combined inhalation and epidural anesthesia.
Subjects and methods: 68 patients were randomized into 2 groups, differed by anesthesia techniques. In Group 1 (GA, n = 34), we used general anesthesia with sevoflurane and fentanyl, while in Group 2 (CA, n = 34) – its combination with epidural anesthesia by 0.5% ropivacaine followed by infusion of 0.2% ropivacaine after OPCAB. Parameters of cardiac performance and ventricular function were assessed by echocardiography.
Results. There were no differences in systolic function of LV, RV, diastolic function of LV between the groups. The difference in the left atrial strain was revealed before hospital discharge and made 18.0 (14.5‒21.5) % in CA Group and 24.0 (18.0–26.0)% in GA Group (p = 0.028).
Conclusions. The use of epidural anesthesia and analgesia is not associated with clinically significant changes in inotropic and lusitropic functions of LV as well as RV systolic function after OPCAB.
About the Authors
K. V. Paromov
E. E. Volosevich First Municipal Clinical Hospital
Russian Federation
Russian Federation
Konstantin V. Paromov Candidate of Medical Sciences, Physician of Cardiac Surgery Intensive Care
1, Suvorova St., Arkhangelsk, 163001
Phone: +7 (8182) 63‒29‒56
D. A. Volkov
E. E. Volosevich First Municipal Clinical Hospital; Northern State Medical University
Russian Federation
Russian Federation
Dmitry A. Volkov Physician of Anesthesiology, Reanimatology and Intensive Care Department
1, Suvorova St., Arkhangelsk, 163001
Phone: +7 (8182) 63‒27‒24
N. V. Nizovtsev
E. E. Volosevich First Municipal Clinical Hospital
Russian Federation
Russian Federation
Nikolay V. Nizovtsev Candidate of Medical Sciences, Physician of Cardiac Surgery Intensive Care
1, Suvorova St., Arkhangelsk, 163001
Phone: +7 (8182) 63‒29‒56
M. Yu. Kirov
E. E. Volosevich First Municipal Clinical Hospital; Northern State Medical University
Russian Federation
Russian Federation
Mikhail Yu. Kirov Doctor of Medical Sciences, Professor, PhD
1, Suvorova St., Arkhangelsk, 163001
Phone: +7 (8182) 63‒29‒86
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Review
For citations:
Paromov K.V., Volkov D.A., Nizovtsev N.V., Kirov M.Yu. Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2020;17(5):6-14. (In Russ.) https://doi.org/10.21292/2078-5658-2020-17-5-6-14
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