Resumo

GUTIERREZ-GUILLEN, A. et al. Influence of epidural analgesia on the incidence of tachyarrhythmia during pulmonary surgery postoperative. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.1, pp.26-30. ISSN 1134-8046.

Objectives: To assess the impact of intra- and post-operative thoracic epidural analgesia (TEA) on the incidence of tachy-arrhythmia after lung resection surgery. Material and methods: Postoperative courses of 200 patients undergoing a major lung resection (lobectomy, bilobectomy or pneumonectomy) were prospectively reviewed in our Hospital between October 1998 and June 2002, a period during which the TEA was progressively introduced in our Service as part of the anaesthetic technique used in pulmonary surgery. The impact of TEA on the incidence of supraventricular tachy-arrhythmias events during the first 48 hours of postoperative was analysed. Results: TEA was used for anaesthetic handling of patients and management of postoperative pain in 49.5% of cases (99/200). There were no significant differences between the groups of patients with and without TEA in terms of age, gender, ASA risk, length of the surgical procedure and type of resection performed. Tachyarrhythmia crises were present in 9.5% of patients (19/200), being always paroxysmal atrial fribrillation. Among patients that did not received TEA, the rate of arrhythmia was 13.86 % (14/101), while in patients that received TEA as part of the anaesthetic technique and during the postoperative, such rate was 5.05% (5/99), being such difference statistically significant (p=0.034). Conclusions: The use of TEA as part of the anaesthetic technique and for the management of postoperative pain after lung resection surgery seems to provide a protective effect in terms of the incidence of atrial fibrillation in the early postoperative. Potential causes of this effect are discussed.

Palavras-chave : Techniques [thoracic epidural analgesia]; Techniques [pulmonary surgery]; Complications [tachyarrhythmia]; Complications [atrial fibrillation].

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