Abstract :
Context and Aims: To assess the efficacy of thoracic epidural analgesia (TEA) for postoperative pain
and effect on haemodynamics, pulmonary functions postoperatively in patients undergoing coronary artery
bypass graft (CABG).
Materials and Methods: Ninety patients posted for elective CABG were randomly allocated using
sealed envelope method into two groups, Group A received injection fentanyl for intraoperative analgesia
and injection tramadol for postoperative analgesia intravenously and Group B received 10 ml of 0.5%
ropivacaine with 50 mg fentanyl as bolus dose epidurally and thereafter, continuous epidural infusion
of 0.2% ropivacaine with 2mg/ml fentanyl at the rate of 8ml/h till the end of surgery for intraoperative
analgesia and then 6-10ml/h till 48h for postoperative analgesia. All patients were given general
anaesthesia. Haemodynamics, arterial blood gases, visual analog scale (VAS) score and peak expiratory
flow rate (PEFR) were reported in ICU till 48h postoperatively.
Statistical analysis used: unpaired t - test and Chi-square test.
Results: Group B showed significantly lesser VAS score, higher PEFR, higher PaO2 and normal values of
PaCO2.
Conclusions: TEA reduces postoperative pain and improves postoperative pulmonary function in patients
undergoing CABG. Also, it is associated with earlier extubation and a wakening, stable haemodynamics
and lesser ICU stay after CABG surgery.
Keyword :
Thoracic epidural analgesia, Postoperative pain, Pulmonary function, Coronary artery bypass graft surgery.