| Thoracic epidural bupivacaine attenuates supraventricular tachyarrhythmias after pulmonary resection. | |
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MedLine Citation:
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PMID: 11473839 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Supraventricular tachyarrhythmias after pulmonary surgery are well described. Some investigators suggest that tachyarrhythmias after thoracic operations may result from the relative sympathotonic status produced by injury to the cardiac parasympathetic nerves. We examined whether postoperative thoracic sympathetic blockade by thoracic epidural bupivacaine might reduce the tachyarrhythmias after pulmonary resection. Fifty patients with lung cancer were randomized to receive epidural bupivacaine (Group B) or epidural morphine (Group M). Patients in Group B were given 6 to 10 mL of 0.25% bupivacaine epidurally, followed by epidural infusion at 3 to 5 mL/h for 3 days, and patients in Group M were given 2 to 3 mg morphine epidurally, followed by morphine infusion at a rate of 0.2 mg/h. Tachyarrhythmias were diagnosed by using the continuous heart rate trend and arrhythmia trend with a central monitoring system. Postoperative analgesia was not statistically different between groups. However, the incidence of postoperative tachyarrhythmias in Group B was significantly less than in Group M (1 of 23 vs 7 of 25, P = 0.0497, Fisher's exact test). The continuous infusion of thoracic epidural bupivacaine can reduce supraventricular tachyarrhythmias compared with epidural morphine infusion, presumably because of attenuation of the sympathotonic status after pulmonary resection. IMPLICATIONS: We examined whether postoperative thoracic sympathetic blockade by thoracic epidural bupivacaine after pulmonary resection might reduce the tachyarrhythmias that may result from the relative sympathotonic status produced by injury to the cardiac parasympathetic nerves. The continuous infusion of thoracic epidural bupivacaine was shown to reduce supraventricular tachyarrhythmias. |
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Authors:
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T Oka; Y Ozawa; Y Ohkubo |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 93 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 2001 Aug |
Date Detail:
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Created Date: 2001-07-27 Completed Date: 2001-08-16 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 253-9, 1st contents page Citation Subset: AIM; IM |
Affiliation:
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Division of Anesthesia, Tochigi Cancer Center Hospital, 4-9-13 Yohnan, Utsonomiya-shi, Tochigi 320-0834, Japan. toka@tcc.pref.tochigi.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anesthesia, Epidural* Anesthetics, Local / pharmacology* Bupivacaine / pharmacology* Female Humans Male Middle Aged Morphine / pharmacology Pneumonectomy / adverse effects* Postoperative Complications / etiology, prevention & control* Tachycardia, Supraventricular / etiology, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Local; 2180-92-9/Bupivacaine; 57-27-2/Morphine |
| Comments/Corrections | |
Comment In:
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Anesth Analg. 2002 May;94(5):1372; author reply 1372
[PMID:
11973231
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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