Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia

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 epidu...

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Main Authors: K. V. Paromov, D. A. Volkov, N. V. Nizovtsev, M. Yu. Kirov
Format: Article
Language:Russian
Published: New Terra Publishing House 2020-11-01
Series:Вестник анестезиологии и реаниматологии
Subjects:
Online Access:https://www.vair-journal.com/jour/article/view/460
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author K. V. Paromov
D. A. Volkov
N. V. Nizovtsev
M. Yu. Kirov
author_facet K. V. Paromov
D. A. Volkov
N. V. Nizovtsev
M. Yu. Kirov
author_sort K. V. Paromov
collection DOAJ
description 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.
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spelling doaj.art-6b05e1aa8f74495ea8d1edc00ea89be82023-09-03T10:33:09ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532020-11-0117561410.21292/2078-5658-2020-17-5-6-14400Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesiaK. V. Paromov0D. A. Volkov1N. V. Nizovtsev2M. Yu. Kirov3ГБУЗ АО «Первая городская клиническая больница им. Е. Е. Волосевич»ГБУЗ АО «Первая городская клиническая больница им. Е. Е. Волосевич»; ФГБОУ ВО «Северный государственный медицинский университет» МЗ РФГБУЗ АО «Первая городская клиническая больница им. Е. Е. Волосевич»ГБУЗ АО «Первая городская клиническая больница им. Е. Е. Волосевич»; ФГБОУ ВО «Северный государственный медицинский университет» МЗ РФThere 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.https://www.vair-journal.com/jour/article/view/460высокая грудная эпидуральная блокадакардиохирургияэхокардиография
spellingShingle K. V. Paromov
D. A. Volkov
N. V. Nizovtsev
M. Yu. Kirov
Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
Вестник анестезиологии и реаниматологии
высокая грудная эпидуральная блокада
кардиохирургия
эхокардиография
title Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
title_full Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
title_fullStr Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
title_full_unstemmed Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
title_short Myocardial function after off-pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
title_sort myocardial function after off pump coronary artery bypass grafting with combined epidural and inhalation anesthesia
topic высокая грудная эпидуральная блокада
кардиохирургия
эхокардиография
url https://www.vair-journal.com/jour/article/view/460
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AT nvnizovtsev myocardialfunctionafteroffpumpcoronaryarterybypassgraftingwithcombinedepiduralandinhalationanesthesia
AT myukirov myocardialfunctionafteroffpumpcoronaryarterybypassgraftingwithcombinedepiduralandinhalationanesthesia