Compare the Efficacy of Thoracic Epidural Anesthesia (TEA) with General Anesthesia (GA) in Thoracic Surgical Comparative Studies to that of Total Intravenous Anesthesia

Sumaya Alwan  Salman; Haider Hussain  Salman

Sumaya Alwan Salman M.B.Ch.B., F.I.B.M.S. 2007 Senior Specialist in Anaesthesia and Intensive Care, Al-Imamain Al-Kadhimain Medical City
Haider Hussain Salman M.B.CH.B., F.I.C.M.S., Consultant in Anesthesia and Intensive Care, Subspeciality in an Interventional Pain Management

Keywords: Thoracic Epidural Anesthesia (TEA), General Anesthesia (GA), Total Intravenous Anesthesia (TIVA), One-Lung Ventilation, Oxygenation, Shunt Fraction, Cardiac Output

Abstract

This study aimed to compare the efficacy of thoracic epidural anesthesia (TEA) combined with general anesthesia (GA) versus total intravenous anesthesia (TIVA) in thoracic surgical procedures, focusing on factors such as shunt fraction, hypoxic pulmonary vasoconstriction, and oxygenation levels during one-lung ventilation. A total of 150 patients with ASA physical status II-III scheduled for lung resection due to pulmonary illness were randomly assigned to two groups: Group A received TIVA with propofol and fentanyl, while Group B received TEA with low-dose isoflurane and bupivacaine. Hemodynamic parameters, oxygenation levels, and shunt fractions were measured before, during, and after surgery. Results indicated that while both anesthetic methods were safe, TEA with GA better preserved arterial oxygenation levels compared to TIVA, potentially due to differences in cardiac output changes. Patients in the TEA group also experienced shorter extubation times and lower postoperative pain scores, suggesting potential benefits for patients with preexisting cardiac issues and decreased oxygenation during one-lung ventilation.

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