Purpose of Review

The purpose of this review is to synthesize and examine the literature on the use of neuraxial anesthesia and analgesia during cardiothoracic surgery. As cardiothoracic procedures often require systemic anticoagulation, neuraxial techniques are quite often underutilized due to the theoretical risk of epidural hematoma. In this review, we seek to examine the literature to review the indications and contraindications and to explore if neuraxial anesthesia and analgesia has a role in cardiothoracic surgery.

Recent Findings

Neuraxial techniques have multiple advantages during cardiothoracic surgery including coronary vasodilation, decreased sympathetic surge, and a decreased cortisol level leading to overall reduction in stress response. Multiple studies have shown an improvement in pain scores, reduction in pulmonary complications, faster extubation times, with minimal complications when neuraxial techniques are utilized in cardiothoracic surgeries.

Summary

Given the numerous advantages and minimal complications of neuraxial techniques in cardiothoracic surgeries, we hope its utilization continues to increase. Moving forward, we hope additional studies continue to reaffirm the benefits of neuraxial anesthesia and analgesia for cardiothoracic surgeries to improve its utilization.

中文翻译：

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心胸外科手术中的椎管内麻醉和镇痛：叙述性回顾

审查目的

本综述的目的是综合和研究心胸外科手术中使用椎管内麻醉和镇痛的文献。由于心胸手术通常需要全身抗凝，由于理论上存在硬膜外血肿的风险，椎管内技术常常未被充分利用。在这篇综述中，我们试图通过查阅文献来回顾适应症和禁忌症，并探讨椎管内麻醉和镇痛在心胸外科手术中是否发挥作用。

最近的发现

椎管内技术在心胸外科手术中具有多种优势，包括冠状血管舒张、减少交感神经激增以及降低皮质醇水平，从而总体减少应激反应。多项研究表明，在心胸外科手术中使用椎管内技术时，疼痛评分得到改善，肺部并发症减少，拔管时间缩短，并发症最小化。

概括

鉴于椎管内技术在心胸外科手术中具有众多优势且并发症极少，我们希望其利用率继续增加。展望未来，我们希望更多的研究继续重申椎管内麻醉和镇痛对心胸外科手术的益处，以提高其利用率。