Thoracic epidural blockade preserves left ventricular early diastolic filling assessed by transesophageal echocardiography

Shiga, Toshiya

doi:10.1007/bf02480758

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Тем не менее есть данные о возможном негативном влиянии десимпатизации на миокард. Так, в ряде публикаций было показано ухудшение его систолической функции на фоне эпидурального введения местных анестетиков [14,[21][22][23]. Вероятно, этот эффект может быть обусловлен фармакологической депрессией миокарда местными анестетиками.…”

Section: влияние эпидуральной анестезии на миокардunclassified

The use of epidural anesthesia in coronary surgery: pro and contra. Review

Volkov

Paromov

Еремеев³

et al. 2020

Annals of Critical Care

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The cardiovascular diseases have top-rated place amongst causes of death all around the world. The leading cardiovascular pathology is coronary artery disease; its course is dependent on severity of atherosclerotic lesion of coronary vessels. Coronary artery bypass grafting (CABG) is one from the most often performed medical techniques of coronary revascularization but has a high risk of perioperative respiratory complications, myocardial infarction, dysrhythmias, kidney dysfunction and other problems. High thoracic epidural anesthesia (HTEA) and analgesia provides sympathetic nerve block of cardiac dermatomes, decreases perioperative stress and pain after CABG, and has a protective role regarding cardiac and respiratory functions. These effects of HTEA are confirmed by a number of studies and systematic reviews. Apart from evident benefits of HTEA, there are restrictions for its use in cardiac surgery associated with increased risk of epidural hematoma followed by neurological consequences. In our review, we describe physiological effects and clinical aspects of using HTEA in coronary surgery.

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Section: влияние эпидуральной анестезии на миокардunclassified

The use of epidural anesthesia in coronary surgery: pro and contra. Review

Volkov

Paromov

Еремеев³

et al. 2020

Annals of Critical Care

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Effects of Thoracic Epidural Anesthesia on Neuronal Cardiac Regulation and Cardiac Function

et al. 2019

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Cardiac sympathetic blockade with high-thoracic epidural anesthesia is considered beneficial in patients undergoing major surgery because it offers protection in ischemic heart disease. Major outcome studies have failed to confirm such a benefit, however. In fact, there is growing concern about potential harm associated with the use of thoracic epidural anesthesia in high-risk patients, although underlying mechanisms have not been identified. Since the latest review on this subject, a number of clinical and experimental studies have provided new information on the complex interaction between thoracic epidural anesthesia–induced sympatholysis and cardiovascular control mechanisms. Perhaps these new insights may help identify conditions in which benefits of thoracic epidural anesthesia may not outweigh potential risks. For example, cardiac sympathectomy with high-thoracic epidural anesthesia decreases right ventricular function and attenuates its capacity to cope with increased right ventricular afterload. Although the clinical significance of this pathophysiologic interaction is unknown at present, it identifies a subgroup of patients with established or pending pulmonary hypertension for whom outcome studies are needed. Other new areas of interest include the impact of thoracic epidural anesthesia–induced sympatholysis on cardiovascular control in conditions associated with increased sympathetic tone, surgical stress, and hemodynamic disruption. It was considered appropriate to collect and analyze all recent scientific information on this subject to provide a comprehensive update on the cardiovascular effects of high-thoracic epidural anesthesia and cardiac sympathectomy in healthy and diseased patients.

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Thoracic epidural blockade preserves left ventricular early diastolic filling assessed by transesophageal echocardiography

Cited by 2 publications

References 21 publications

The use of epidural anesthesia in coronary surgery: pro and contra. Review

The use of epidural anesthesia in coronary surgery: pro and contra. Review

Effects of Thoracic Epidural Anesthesia on Neuronal Cardiac Regulation and Cardiac Function

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