Thoracic epidural blockade preserves left ventricular early diastolic filling assessed by transesophageal echocardiography.

PURPOSE

The objective of this study was to examine the effect of thoracic epidural anesthesia (TEA) on left ventricular systolic and diastolic function assessed by transesophageal echocardiography under general anesthesia.

METHODS

Sixteen patients were allocated to control (n=8) and TEA (n=8) groups. We administered 1% mepivacaine (8.9±1.2 ml) into the thoracic epidural space in the TEA group.

RESULTS

The concomitant decline of the left vertricular systolic functional parameters, such as end-systolic diameter and fractional shortening, was observed, whereas preload, as measured by end-diastolic diameter, and afterload, as measured by end-systolic wall stress, were unchanged. No significant alteration was observed in early peak velocity or deceleration rate. The deceleration time was independent of heart rate and was unchanged.

CONCLUSION

High TEA reduces fractional shortening without any changes in preload and afterload, indicating impairment of systolic function, but early peak velocity, deceleration rate, and deceleration time, which are the indices of diastolic function, are not changed during high TEA combined with general anesthesia.