Thoracic epidural anaesthesia for treatment of refractory angina pectoris

Unstable angina is a dangerous condition with a high risk of developing myocardial infarction. The atherosclerotic plaque is exceedingly inflammatory and the unstable condition is due to a plaque rupture changing the anatomic configuration and associated with activation of the sympathetic nervous sy...

Full description

Saved in:
Bibliographic Details
Published in:Best practice & research. Clinical anaesthesiology 1999-04, Vol.13 (1), p.83-99
Main Authors: Blomberg, Sture G., Svorkdal, Nelson
Format: Article
Language:English
Subjects:
atherosclerosis
serotonin
thoracic epidural anesthesia
thromboxane A2
unstable angina
vasoconstriction
α-adrenoceptors
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Unstable angina is a dangerous condition with a high risk of developing myocardial infarction. The atherosclerotic plaque is exceedingly inflammatory and the unstable condition is due to a plaque rupture changing the anatomic configuration and associated with activation of the sympathetic nervous system and stenotic vasoconstriction and thrombosis. In spite of nitrates, β-blockers, calcium blockers and anti-platelet and anti-thrombotic drugs, there is refractory angina in about 10% of cases. These patients may successfully be treated with high thoracic epidural anaesthesia (HTEA), which is anti-anginal and anti-ischemic; if they are inoperable they can be discharged for long-term home self-treatment with tunnelled or inplantable HTEA devices. These have a low cost and are simple to insert and easy to handle, with a low risk for complications. There is also a decreasing need for injections with time, which may be explained by less tissue damage or intimal hyperplasia due to the sympathetic blockade.
ISSN:1521-6896
1532-169X
DOI:10.1053/bean.1999.0009