[Hemodynamic aspects of thoracic epidural analgesia]

Twenty-seven experimental and clinical studies on hemodynamic changes during thoracic epidural analgesia (TEA) are reviewed. It is concluded, that TEA exerts negative chronotropic, inotropic, dromotropic and bathmotropic effects on the heart. The systemic vascular resistance as well as cardiac output are diminished, and a substantial reduction in the myocardial oxygen consumption is also seen. Under close monitoring of the cardiovascular status, TEA seems suitable for surgery in patients with ischemic heart disease. Furthermore, the use of TEA with moderate dosage of the local analgesic agent could be a supplement in the treatment of severe angina pectoris.