• Murali Chakravarthy, Vivek Jawali, Thimmannagowda A Patil, Krishnamoorthy Jayaprakash, Srinivasan Kolar, Gilbert Joseph, Jayant Kumar Das, Uma Maheswari, and Nachu Sudhakar.
• Wockhardt Heart Institute, Bangalore, Karnataka, India. chakravarthy@vsnl.com
• J. Cardiothorac. Vasc. Anesth. 2005 Jun 1; 19 (3): 300-5.

ObjectiveThe purpose of this study was to evaluate the feasibility of thoracic epidural anesthesia as an alternative technique to general anesthesia in patients undergoing cardiac surgery under cardiopulmonary bypass.DesignA prospective study.SettingTertiary referral heart hospital.ParticipantsEleven patients underwent cardiac surgical procedures requiring cardiopulmonary bypass under thoracic epidural anesthesia from February to April 2004.InterventionsAn epidural catheter was inserted at C7 to T2 intervertebral space on the day before the operation. Subsequently, cardiac surgery was performed using cardiopulmonary bypass.Measurements And ResultsThe midsternotomy approach was used in all the patients. Anticoagulation was achieved with 300 units/kg of heparin. Under normothermic cardiopulmonary bypass, 6 patients underwent closure of atrial septal defect, 3 underwent valve replacements, and 2 underwent coronary artery bypass surgery combined with valve replacements. Soon after establishing cardiopulmonary bypass, all but 1 patient developed apnea, which was reversed after termination of cardiopulmonary bypass. The mean cardiopulmonary bypass time was 102 +/- 28 minutes, the aortic cross-clamp time was 58 +/- 28 minutes, and the total duration of surgery was 229 +/- 64 minutes. There was no mortality or morbidity in this series.ConclusionCardiac surgical procedures requiring cardiopulmonary bypass may be performed under thoracic epidural anesthesia, without endotracheal general anesthesia.

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