Faculty Collaboration Database

Thoracic epidural analgesia: its role in postthoracotomy atrial arrhythmias. J Cardiothorac Vasc Anesth 2000 Dec;14(6):662-5

Date

01/04/2001

Pubmed ID

11139105

DOI

10.1053/jcan.2000.18318

Scopus ID

2-s2.0-0033675271 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

OBJECTIVE: To determine the effects of thoracic epidural analgesia (TEA) management on the incidence of atrial arrhythmias (AAs) after thoracotomy for lung resection.

DESIGN: Retrospective.

SETTING: A major university medical center.

PARTICIPANTS: The medical records of 185 consecutive patients who underwent thoracotomy between 1993 and 1997 were reviewed; patients with TEA only were included in the analysis.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: There was a 20% incidence of AAs after thoracotomy. Preoperative predictors of AAs were age >65 years, cardiac history, and an abnormal electrocardiogram (ECG). There was a temporal relationship between epidural catheter removal and occurrence of AAs. Fourteen patients developed AAs before TEA catheter removal, whereas 29 patients developed AAs after TEA catheter removal (p = 0.01). There was no relationship between anatomic site of epidural catheter placement or choice of epidural agent and AAs.

CONCLUSIONS: AAs after thoracotomy were common. These AAs were associated with increased age, cardiac history, abnormal ECG, increased cost, increased length of hospital stay, and time of epidural catheter removal. Although a cause-and-effect relationship cannot be inferred from this study, the presence or absence of TEA was found to have a temporal relationship with the incidence of AAs.

Author List

Groban L, Dolinski SY, Zvara DA, Oaks T

Author

Sylvia Dolinski MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Analgesia, Epidural
Arrhythmias, Cardiac
Electrocardiography
Female
Heart Atria
Humans
Male
Middle Aged
Postoperative Complications
Pulmonary Surgical Procedures
Retrospective Studies
Risk Factors
Thoracotomy
Time Factors