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High epidural thoracic anesthesia for pericardial surgery.
P De Bellis1, R Delfino, F Robbiano
1Department of Anesthesia and Intensive Care, San Martino Hospital, largo R. Benzi 10, 16132 Genoa, Italy. debellispasquale@fastwebnet.it
Minerva Anestesiologica
|September 16, 2005
Summary
This study shows that awake pleuropericardial window surgery using thoracic epidural anesthesia is a safe and effective technique for recurrent pericardial effusion. Patients remained stable and experienced excellent pain control throughout the procedure.
Area of Science:
- Cardiothoracic Surgery
- Anesthesiology
- Pericardial Diseases
Background:
- Recurrent pericardial effusion poses a significant clinical challenge.
- Surgical intervention like pleuropericardial window is often necessary.
- General anesthesia with endotracheal intubation is the standard approach.
Observation:
- Three patients (77, 61, 58 years old) with recurrent pericardial effusion underwent awake pleuropericardial window.
- Thoracic epidural anesthesia (T1-T2 or T2-T3) was used, avoiding endotracheal intubation.
- Patients remained fully awake during the procedure.
Findings:
- Operative and postoperative courses were uneventful for all patients.
- Vital parameters and spontaneous ventilation remained stable during pneumothorax.
- Excellent pain control was achieved throughout the surgical process.
Implications:
- Awake thoracotomy for cardiac procedures is a reproducible technique.
- Thoracic epidural anesthesia offers a viable alternative for awake cardiac surgery.
- This approach may improve patient outcomes and reduce anesthesia-related risks.