High Thoracic Epidural Analgesia for the Control of Pain in Unstable Angina Pectoris -A case report-

2006 ◽  
Vol 19 (2) ◽  
pp. 271
Author(s):  
Bong Jae Lee
Keyword(s):  
Case Report ◽  
Angina Pectoris ◽  
Epidural Analgesia ◽  
Unstable Angina ◽  
Thoracic Epidural Analgesia ◽  
Unstable Angina Pectoris ◽  
Thoracic Epidural ◽  
High Thoracic Epidural

scholarly journals An Audit of Morphine versus Fentanyl as an Adjunct to Ropivacaine 0.2% for High Thoracic Epidural Analgesia

2005 ◽  
Vol 33 (5) ◽  
pp. 639-644 ◽  
Author(s):  
C. F. Royse ◽  
A. G. Royse ◽  
D. A. Deelen
Keyword(s):  
Epidural Analgesia ◽  
Respiratory Depression ◽  
Infusion Rate ◽  
Artery Bypass ◽  
Visual Analogue Score ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
Sole Agent ◽  
Retrospective Audit ◽  
High Thoracic Epidural

When used as an adjunct to local anaesthetic, opioid administered via the epidural route can improve the quality of analgesia. Reports of respiratory depression associated with epidural morphine use as a sole agent in the 1980s led to an increased use of lipophilic opioids, especially fentanyl. Although fentanyl is commonly used, controversy exists about its efficacy and site of action. It is possible that low-dose morphine may be more effective than fentanyl, without increasing the risk of respiratory depression. A retrospective audit was conducted of 200 consecutive patients undergoing coronary artery bypass surgery who received high thoracic epidural analgesia. One hundred patients who received fentanyl 2 μg/ml with 0.2% ropivacaine, prior to a change in our technique, were audited, followed by 100 patients who received 20 μg/ml morphine with 0.2% ropivacaine. Outcome measures included the incidence of Visual Analogue Score (VAS) ≥4/10; infusion rate adjustments; and side-effects. Patients receiving fentanyl were more likely to experience pain ≥4/10 (P'=0.002); the infusion rate was higher (P8=0.024); required more rate adjustments (P8=0.001); a greater need for noradrenaline (P'=0.001) and antiemetic drugs (P'=0.001). There were no significant differences between the groups for sedation scores or the incidence of respiratory depression. This audit suggests morphine 20 μg/ml may be superior to fentanyl 2 μg/ml, as an adjunct to 0.2% ropivacaine. We found a reduced number of infusion interventions and less inadequate patient analgesia.

Effect of thoracic epidural analgesia on refractory angina pectoris: Long-term home self-treatment

2002 ◽  
Vol 16 (6) ◽  
pp. 679-684 ◽  
Author(s):  
Arina Richter ◽  
Ingemar Cederholm ◽  
Lena Jonasson ◽  
Carlo Mucchiano ◽  
Michael Uchto ◽  
...  
Keyword(s):  
Angina Pectoris ◽  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Refractory Angina ◽  
Thoracic Epidural ◽  
Refractory Angina Pectoris

HIGH THORACIC EPIDURAL ANALGESIA (HTEA)

1999 ◽  
Vol 88 (Supplement) ◽  
pp. 81SCA
Author(s):  
PM Gramling-Babb ◽  
&NA; Zile ◽  
ST Reeves
Keyword(s):  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
High Thoracic Epidural

Reply: High Thoracic Epidural Analgesia and Cardiac Performance

2013 ◽  
Vol 27 (3) ◽  
pp. e35
Author(s):  
Carl-Johan Jakobsen ◽  
Dorthe Viemose Nielsen ◽  
Pia Katarina Ryhammer ◽  
Rajesh Bhavsar ◽  
Erik Sloth ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Cardiac Performance ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
High Thoracic Epidural
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