Thoracic Epidural Analgesia In Fast-Track Cardiac Surgery

SummaryFast track surgery combines various techniques used in the care of patients undergoing cardiac operations. The methods used include epidural or regional anesthesia, minimally invasive techniques, optimal pain control and aggressive postoperative rehabilitation.Combination of these approaches reduces stress response and organ dysfunction and therefore greatly shorten the time to extubation and so the length of ICU stay.The objectives of the present study is to determine the effect of TEA on time to extubation and also to determine if postoperative analgesia from TEA could decrease the time taken to achieve criteria for ICU discharge.The study was carried out on sixty adult patients scheduled for elective cardiac surgery allocated into two equal groups; group one (fentanyl group) in which fentanyl was used as a systemic analgesia and group two (thoracic epidural group) in which thoracic epidural analgesia was used.The results of the present study revealed that the extubation time was highly significantly lowered in TEA group. In addition, the ICU stay time was significantly reduced in TEA group when compared to fentanyl group.Also, our results revealed that pain scores on visual analogue scale were highly significantly lower in TEA group. Good analgesia achieved by TEA results in more cardiovascular stability and better preserved pulmonary functions in TEA more than in fentanyl group.Finally, we revealed in our present study that no patient suffered from awareness in both groups (0%).