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Awake cardiac surgery using a novel anesthetic technique
Thomas M Hemmerling1, Nicolas Noiseux, Fadi Basile
1PeriCARG (Perioperative Cardiac Research Group), Department of Anesthesiology, Centre Hospitalier de l'Université de Montréal, Hôtel-Dieu, Québec H2W 1T8, Canada. thomashemmerling@hotmail.com
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|December 6, 2005
Summary
Awake cardiac surgery is feasible in Canada using a novel combined femoral block and high thoracic epidural anesthesia. This technique facilitated off-pump coronary artery bypass grafting (OPCAB) with rapid recovery and discharge.
Area of Science:
- Anesthesiology
- Cardiovascular Surgery
- Thoracic Anesthesia
Background:
- General anesthesia is standard for cardiac surgery, but carries risks.
- Awake cardiac surgery offers potential benefits but requires effective anesthesia.
- Novel anesthetic techniques are needed to expand options for awake cardiac procedures.
Observation:
- Two patients underwent off-pump coronary artery bypass grafting (OPCAB) using a combined femoral block and high thoracic epidural anesthesia.
- Both procedures were completed without hemodynamic or respiratory complications.
- Patients experienced uneventful recovery and were discharged within five days.
Findings:
- The combined femoral block and high thoracic epidural anesthesia technique is effective for awake OPCAB.
- This anesthesia approach allows for cardiac surgery and saphenous vein harvesting.
- The technique demonstrated feasibility in the first published Canadian cases.
Implications:
- Awake OPCAB is a viable option for select patients.
- Further clinical experience is needed to establish technical limitations.
- This technique may play a role in the future of cardiac surgery, warranting further study.