What are the potential risks associated with the use of high thoracic epidural anesthesia in CABG patients?
Potential risks associated with the use of high thoracic epidural anesthesia in CABG patients include neuraxial bleeding, local anesthetic toxicity, logistical issues related to the timing of epidural catheter insertion and management, the occurrence of epidural hematoma or abscess, and other regional anesthetic approaches for postoperative analgesia, such as parasternal block. Meta-analyses of randomized controlled trials (RCTs) of high thoracic epidural anesthesia/ analgesia in CABG patients (particularly on-pump) have yielded inconsistent results on morbidity and mortality rates. Although none of the RCTs have reported the occurrence of epidural hematoma or abscess, these entities occur on occasion.38