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Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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LETTER TO EDITOR Table of Contents   
Year : 2009  |  Volume : 12  |  Issue : 2  |  Page : 168-169
Author's response


Director of Cardiac Anesthesia, Department of Anesthesia and Critical Care, University of Chicago, 5841 South Maryland Avenue,MC 4028 Chicago, Illinois 60637, USA

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Date of Web Publication21-Jul-2009
 

How to cite this article:
Chaney MA. Author's response. Ann Card Anaesth 2009;12:168-9

How to cite this URL:
Chaney MA. Author's response. Ann Card Anaesth [serial online] 2009 [cited 2022 Dec 8];12:168-9. Available from: https://www.annals.in/text.asp?2009/12/2/168/53431


The Editor,

I truly appreciate the time and energy the authors spent crafting their comments. Their passion attests to the extremely controversial nature [1],[2] surrounding the use of thoracic epidural techniques in patients undergoing cardiac surgery. This is indeed a very polarizing topic. It seems as if individual anesthesiologists think this practice is either 'insane' or 'fantastic', with no middle ground.

Most of the statements presented in these Letters are true. However, some are not supported by a critical review of the existing literature. My responses to their statements can be found in the original Editorial, thus I will not repeat them here. [3]

Of course, we need to provide appropriate postoperative analgesia in patients following cardiac surgery. These are the facts: Thoracic epidural techniques provide postoperative analgesia, are labor intensive, increase catastrophic and non-catastrophic risk and are associated with a high failure rate. Their use in patients undergoing cardiac surgery has no proven clinical benefits beyond initiation of postoperative analgesia. To me, the use of traditional intravenous opioids (more appealing risk : benefit ratio) in these patients is a better choice.

 
   References Top

1.Royse CF. High thoracic epidural analgesia for cardiac surgery: time to move from morbidity to quality of recovery indicators. Ann Card Anaesth 2009;12:168.  Back to cited text no. 1    
2.Kapoor PM, Choudhury M, Kakani M. Thoracic epidural anesthesia in cardiac surgery - current standing. Ann Card Anaesth 2009;12:167-69.  Back to cited text no. 2  [PUBMED]  Medknow Journal
3.Chaney MA. Thoracic epidural anaesthesia in cardiac surgery - the current standing (Invited Editorial). Ann Card Anaesth 2009:12;1-3.  Back to cited text no. 3    

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Correspondence Address:
Mark A Chaney
Director of Cardiac Anesthesia, Department of Anesthesia and Critical Care, University of Chicago, 5841 South Maryland Avenue,MC 4028 Chicago, Illinois 60637
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.53431

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