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Editorials |

Epidural Anesthesia/Analgesia and Coronary Artery Bypass Surgery Utilizing Extracorporeal Circulation

Bradley E. Smith, MD
Author and Funding Information

Affiliations: Nashville, TN
 ,  Dr. Smith is Professor of Anesthesiology Emeritus, Adjunct Professor of Anesthesiology, Vanderbilt University School of Medicine.

Correspondence to: Bradley E. Smith, MD, Professor of Anesthesiology Emeritus, Adjunct Professor of Anesthesiology, Vanderbilt University School of Medicine, PO Box 128543, Nashville, TN 37212-4853; e-mail: bradley.smith@vanderbilt.edu



Chest. 2005;128(3):1097-1099. doi:10.1378/chest.128.3.1097
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In of this issue of CHEST (see page 1564), Lundstrøm and colleagues1 present a prospective, randomized, and controlled study of the incidence of hypoxemic episodes following surgery for coronary artery bypass graft (CABG) surgery utilizing extracorporeal circulation (ECC). (Note: CABG without ECC is not discussed here.) Control subjects (CONs) received general anesthesia followed by postsurgical pain control therapy with opioid-based medications. In addition, the “test” group also received anesthesia and pain control medication via an indwelling catheter in the thoracic epidural space (TEAA). These authors failed to demonstrate any protective effect of the use of the indwelling catheter in the TEAA on postsurgical hypoxemic episodes. In fact, on the third postsurgical night, hypoxemic episodes occurred in 100% of the patients in the TEAA group and in only 76% of the subjects in the CON group (p < 0.05).


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