caa a22 4500 445373806 CHVBK 20180317142956.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00540-011-1159-7 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1159-7 Postoperative outcome in awake, on-pump, cardiac surgery patients [Elektronische Daten] [Michal Porizka, Martin Stritesky, Michal Semrad, Milos Dobias, Alena Dohnalova] Purpose: Thoracic epidural anesthesia (TEA) alone or combined with general anesthesia (TEA-GA) has been assumed to improve early postoperative outcome in cardiac surgery. The aim of our study was to investigate data of early and late postoperative outcome results of awake TEA patients undergoing cardiac surgery with comparison to patients under combined and general anesthesia (GA). Methods: Forty-seven patients undergoing elective on-pump cardiac surgery were assigned to receive either epidural (group TEA, n=17), combined (group TEA-GA, n=15), or general (group GA, n=15) anesthesia. Early and late postoperative outcome data, including hospital and 3-year mortality rates, were recorded and compared among the study groups. Results: There was no major difference in early or late postoperative outcome data across all study groups, except for lower incidence of atrial fibrillation in the TEA group compared with the GA group (23.5% vs. 66.7%, respectively, P<0.05). Also, TEA and TEA-GA groups compared with the GA group had lower pain visual analogue scale scores at 24h postoperatively (4±7, 6±7, 14.7±11, respectively, P<0.05) and morphine requirements during the first 24h after surgery (30±6, 30±6, 250±140μg/kg, respectively, P<0.05). Conclusions: Based on our data, all three anesthetic methods were equivalent in terms of major determinants of postoperative outcome, except for lower incidence of atrial fibrillation in awake patients compared with patients under general anesthesia. Methods using postoperative epidural analgesia provided superior pain relief. Japanese Society of Anesthesiologists, 2011 Cardiac surgery nationallicence Thoracic epidural anesthesia nationallicence Cardiopulmonary bypass nationallicence Postoperative outcome nationallicence Mortality nationallicence Porizka Michal Department of Anesthesiology and Intensive Care, General Teaching Hospital, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut Stritesky Martin Department of Anesthesiology and Intensive Care, General Teaching Hospital, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut Semrad Michal 2nd Department of Surgery, Department of Cardiovascular Surgery, General Teaching Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic aut Dobias Milos Department of Anesthesiology and Intensive Care, General Teaching Hospital, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut Dohnalova Alena Department of Statistics, First Faculty of Medicine, Charles University, Prague, Czech Republic aut Journal of Anesthesia Springer Japan 25/4(2011-08-01), 500-508 0913-8668 25:4<500 2011 25 540 https://doi.org/10.1007/s00540-011-1159-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1159-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Porizka Michal Department of Anesthesiology and Intensive Care, General Teaching Hospital, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Stritesky Martin Department of Anesthesiology and Intensive Care, General Teaching Hospital, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Semrad Michal 2nd Department of Surgery, Department of Cardiovascular Surgery, General Teaching Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic aut NATIONALLICENCE 700 1- Dobias Milos Department of Anesthesiology and Intensive Care, General Teaching Hospital, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Dohnalova Alena Department of Statistics, First Faculty of Medicine, Charles University, Prague, Czech Republic aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/4(2011-08-01), 500-508 0913-8668 25:4<500 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer