The influence of high thoracic epidural analgesia on the cardiovascular system

The effect of high thoracic epidural analgesia (TEA) on the cardiovascular system was investigated in 10 patients (5 with cardiovascular disease and 5 without known cardiovascular disorder), who were scheduled for a thoracotomy. An epidural catheter was inserted at T1-T2 level. Plain bupivacaine (Marcaine) 0.5%, 4 to 6 ml was used and resulted in a mean analgesic level from C7 to T5. TEA did not significantly affect the following parameters: heart rate, mean arterial pressure, cardiac index, central venous pressure, pulmonary capillary wedge pressure, stroke volume index, systemic vascular resistance, pulmonary vascular resistance, right and left ventricular stroke work index. From this study it is concluded that high TEA with bupivacaine has only minor effects on the cardiovascular system.