alexa Update in thoracic epidural anaesthesia.
Anesthesiology

Anesthesiology

Journal of Anesthesia & Clinical Research

Author(s): Waurick R, Van Aken H

Abstract Share this page

Abstract Thoracic epidural analgesia (TEA) provides optimal perioperative anaesthesia and analgesia after thoracic and major abdominal surgery and decreases postoperative morbidity and mortality, mainly by blocking sympathetic nerve fibres. Surgery leads to a stress response characterized by sympathetic arousal, altered balance of catabolic and anabolic hormones, hypermetabolism, negative protein economy, and altered carbohydrate metabolism and immune function. A threefold increase of the plasma level of norepinephrine (noradrenaline) was detected up to 24 hours after surgery. These elevated catecholamine plasma levels are a risk, especially to patients with coronary artery disease, because unlike healthy coronary arteries, the stress response causes a vasoconstriction in arteriosclerotic coronary arteries. TEA results in a vasodilation in stenotic coronary arteries. In patients with instable angina pectoris, TEA reduced the number as well as the duration of episodes of cardiac ischaemia. Furthermore, TEA improves myocardial structure and function after coronary artery bypass grafting. Plasma levels of troponin T and I, as well as of atrial natriuretic peptides, were reduced and echocardiographic parameters of the ventricular wall motion were improved by TEA. Patients showed fewer arrhythmic episodes and postoperative myocardial infarction, and could be extubated earlier. The positive effects of TEA after coronary artery bypass grafting are not limited to a short postoperative period, the 2-year mortality rate also seems to be reduced. Optimized pain control and early mobilization decrease the riskof pulmonary complications, resulting in a shortened stay in intensive care units. In combination with early enteral nutrition, TEA leads to an earlier return of gastrointestinal function. Patients treated with thoracic epidural anaesthesia and analgesia have a better health-related quality of life.
This article was published in Best Pract Res Clin Anaesthesiol and referenced in Journal of Anesthesia & Clinical Research

Relevant Speaker PPTs

Recommended Conferences

OMICS International Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsonline.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsonline.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsonline.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsonline.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsonline.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsonline.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsonline.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsonline.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsonline.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsonline.com

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

materialsci@omicsonline.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsonline.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsonline.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsonline.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsonline.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsonline.com

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version