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20-03-2024 | Heart Surgery | New and Emerging Therapies in Interventional Pain Medicine (J Hasoon, Section Editor)

Neuraxial Anesthesia and Analgesia During Cardiothoracic Surgery: A Narrative Review

Authors: Kevin Chen, Kyle Gashler, Tommy Li, Anvinh Nguyen

Published in: Current Pain and Headache Reports

Abstract

Purpose of Review

The purpose of this review is to synthesize and examine the literature on the use of neuraxial anesthesia and analgesia during cardiothoracic surgery. As cardiothoracic procedures often require systemic anticoagulation, neuraxial techniques are quite often underutilized due to the theoretical risk of epidural hematoma. In this review, we seek to examine the literature to review the indications and contraindications and to explore if neuraxial anesthesia and analgesia has a role in cardiothoracic surgery.

Recent Findings

Neuraxial techniques have multiple advantages during cardiothoracic surgery including coronary vasodilation, decreased sympathetic surge, and a decreased cortisol level leading to overall reduction in stress response. Multiple studies have shown an improvement in pain scores, reduction in pulmonary complications, faster extubation times, with minimal complications when neuraxial techniques are utilized in cardiothoracic surgeries.

Summary

Given the numerous advantages and minimal complications of neuraxial techniques in cardiothoracic surgeries, we hope its utilization continues to increase. Moving forward, we hope additional studies continue to reaffirm the benefits of neuraxial anesthesia and analgesia for cardiothoracic surgeries to improve its utilization.

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Title: Neuraxial Anesthesia and Analgesia During Cardiothoracic Surgery: A Narrative Review
Authors: Kevin Chen
Kyle Gashler
Tommy Li
Anvinh Nguyen
Publication date: 20-03-2024
Publisher: Springer US
Keywords: Heart Surgery
Heart Surgery
Epidural Hematoma
General Anesthesia
Opioids
Opioids
Spinal Anesthesia
Published in: Current Pain and Headache Reports
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-024-01235-5

At a glance: The STEP trials

Springer Medicine

Neuraxial Anesthesia and Analgesia During Cardiothoracic Surgery: A Narrative Review

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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