The use of double catheter epidural anesthesia in the lumbar segment of the spine during surgical correction of funnel chest deformity

2012 ◽  
Vol 93 (4) ◽  
pp. 654-656
Author(s):  
R R Safin ◽  
O G Anisimov
Keyword(s):  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Comparison Group ◽  
Main Group ◽  
Surgical Correction ◽  
Thoracic Epidural Anesthesia ◽  
Congenital Deformity ◽  
Funnel Chest ◽  
Thoracic Epidural ◽  
Chest Deformity

Aim. To provide clinically effective epidural anesthesia during corrective thoracoplasty in children with congenital deformity of the chest with the use of an access, which makes it possible to minimize the probability of accidental spinal cord injury during the procedure. Methods. Conducted was a prospective study of 40 adolescents randomized to the main group (thoracic epidural anesthesia combined with general anesthesia) and the comparison group (general anesthesia), 20 observations in each group. In order to evaluate the effectiveness of the method at the time of surgery determined was the level of cortisol and glucose, and after the operation recorded were the times of resolution of the pneumothorax and of the intensity of pain. Results. In the main group a slight decrease in the biochemical markers of stress was noted in contrast to their moderate increase by the end of the operation in the comparison group. Associated complications and pain in the postoperative period in the main group were expressed to a lesser extent than in the comparison group. Conclusion. Thoracic epidural anesthesia combined with general anesthesia may be the method of choice during surgical correction of the funnel chest deformity.

scholarly journals May awake video-assisted thoracoscopic surgery with thoracic epidural anesthesia use routinely for minimaly invasive thoracic surgery procedures in the future?

2018 ◽  
Vol 5 (5) ◽  
pp. 1602
Author(s):  
Gonul Sagiroglu ◽  
Fazli Yanik ◽  
Yekta A. Karamusfaoglu ◽  
Elif Copuroglu
Keyword(s):  
Thoracic Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Thoracoscopic Surgery ◽  
Lung Ventilation ◽  
Thoracic Epidural Anesthesia ◽  
One Lung Ventilation ◽  
Thoracic Epidural ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Background: In the last years thoracic surgery developed in greater extent with equipments and techniques in one lung ventilation. Still general anesthesia in one lung ventilation approved as gold standard. In thoracic surgery most performed surgeries are plerural decortication and lung biopsy. Avoidance of intubation in Video Assisted Thoracoscopic Surgery (VATS) procedures gains us some advantages in postoperative period; a better respiratory parameters, survival and morbidity mortality rates, reduced hospitalization time and costs, reduced early stress hormone and immune response.  Methods: In this study, we reported our experience of 24 consecutive patients undergoing VATS with Thoracic Epidural Anesthesia (TEA) between December 2015 through July 2016 to evaluate the feasibility, safety and indication of this innovative technique whether it will be a gold standart in thoracic surgeries or not in the future.Results: Operation procedures included wedge resection in 11 (46%) patients (eight of them for pneumothorax, three of them for diagnosis), in 10 (42%) patients pleural biopsy (eight of them used talc pleurodesis), in two (8%) patients air leak control with fibrin glue and in one (4%) patient bilateral thoracal sympathectomy for hyperhidrosis.  We used T4-5 TEA space for 17 (72%) of patients, while we used T4-6 TEA space for 7 (28%) of patients. TEA block reached the desired level after the mean 26.4±4.3 minutes (range 21-34 min). There was no occurrence of hypotension and bradycardia during and after TEA. One (4%) patient required conversion to general anesthesia and tracheal intubation because of significant diaphragmatic contractions and hyperpne. Conversion to thoracotomy was not needed in any patient.Conclusions: We conclude that nVATS procedure with aid of TEA is feasibile and safety with minimal adverse events. The procedure can have such advantages as early mobilization, opening of early oral intake, early discharge, patient satisfaction, low pain level. Nevertheless, there is a need for randomized controlled trials involving wider case series on the subject.

Thoracic Epidural Anesthesia Combined with General Anesthesia: The Preferred Anesthetic Technique for Thoracic Surgery

2001 ◽  
Vol 92 (4) ◽  
pp. 848-854 ◽  
Author(s):  
Vera Von Dossow ◽  
Martin Welte ◽  
Ulrich Zaune ◽  
Eike Martin ◽  
Michael Walter ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Thoracic Epidural Anesthesia ◽  
Anesthetic Technique ◽  
Thoracic Epidural

scholarly journals Comparison of Outcomes of Combined Thoracic Epidural Anesthesia with General Anesthesia Verus General Anesthesia During Coronary Artery Bypass Graft Surgery

2016 ◽  
Author(s):  
Lana Keker
Keyword(s):  
Coronary Artery ◽  
General Anesthesia ◽  
Coronary Artery Bypass ◽  
Epidural Anesthesia ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Thoracic Epidural Anesthesia ◽  
Artery Bypass Graft ◽  
Thoracic Epidural ◽  
Randomized Controlled

<p>Coronary artery bypass graft (CABG) surgery is the most common type of heart surgery in the United States. The main benefit of CABG surgery is a significant decrease in myocardial infarction rate, while the most common complications of CABG are myocardial damage and atrial fibrillation. The incorporation of epidural anesthesia occurred in order to decrease sympathetic nervous system response during CABG but has not been extensively studied. A systematic review was conducted to compare the cardiovascular outcomes of the addition of thoracic epidural anesthesia to the anesthetic plan versus general anesthesia as a solo technique during coronary artery bypass grafting surgery. The PubMed database was searched to identify randomized controlled trials in adult patients undergoing CABG with implementation of thoracic epidural anesthesia versus general anesthesia only. Seven studies involving 668 participants met the criteria. A previously published meta- analysis of randomized controlled trials was also included. The Preferred Reporting Items for Systematic Review (PRISMA) checklist was utilized to extrapolate and synthetize the data. The Critical Appraisal Sheet for Controlled Randomized Studies was adapted from the FRISBE tool in order to compare both within and across the studies. Two outcomes were measured: the degree of cardiac damage that was represented by troponin level and atrial fibrillation rate. The limited evidence suggested that thoracic epidural anesthesia does not provide cardioprotective benefits in adult patients undergoing CABG. The results of the study should be interpreted with caution due to the limited information available and heterogeneity of the studies. The question of whether thoracic epidural anesthesia provides cardioprotective functions requires further investigation. Taking into consideration the results of this study, it is not recommended to use the epidural anesthesia as an adjunct technique on the routine basis during CABG until more information is available.</p>

The Effects of Thoracic Epidural Anesthesia on Hepatic Blood Flow in Patients Under General Anesthesia

2009 ◽  
Vol 108 (4) ◽  
pp. 1331-1337 ◽  
Author(s):  
Rainer Meierhenrich ◽  
Florian Wagner ◽  
Wolfram Schütz ◽  
Michael Rockemann ◽  
Peter Steffen ◽  
...  
Keyword(s):  
Blood Flow ◽  
General Anesthesia ◽  
Hepatic Blood Flow ◽  
Epidural Anesthesia ◽  
Thoracic Epidural Anesthesia ◽  
Thoracic Epidural

THORACIC EPIDURAL ANESTHESIA ASSOCIATED WITH LIGHT GENERAL ANESTHESIA IN HIGH RISK SURGICAL PATIENTS

1988 ◽  
Vol 69 (3A) ◽  
pp. A181-A181 ◽  
Author(s):  
B. Gentil ◽  
J. F. Baron ◽  
P. Coriat ◽  
W. Benhalima ◽  
M. Arthaud ◽  
...  
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Surgical Patients ◽  
Thoracic Epidural Anesthesia ◽  
Thoracic Epidural
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