Epidural anesthesia in coronary artery bypass grafting surgery

Thoracic epidural anesthesia may affect the outcome of patients undergoing coronary artery bypass graft surgery beneficially by producing superlative perioperative analgesia, stress response attenuation, and cardiac sympatholysis. The technique of instrumentation in combination with full intraoperative heparinization, however, may risk potentially serious adverse effects and undesirable drug effects. This article attempts to establish whether a favorable risk/benefit ratio exists and to clarify the role of sympatholysis by thoracic epidural anesthesia in cardiac surgery.