Open Lobectomies and Cardiac Biomarkers

vol.17 No1 (2022)

Abstract

Objective: Troponin is a sensitive biomarker for cardiovascular injury. In lobectomies, perioperative analgesia can be performed with either a combination of thoracic epidural anesthesia and general anesthesia or general anesthesia alone. We wish to demonstrate that patients who receive the former tend to have lower levels of troponin.

Method: In this prospective observational study, we included patients who underwent open lobectomy. Cardiovascular markers were recorded postoperatively, in order to correlate the fluctuation of these markers with the application or not of thoracic epidural anesthesia.

Results: Forty eight (48) patients were enrolled, 15 (31.3%) received a combination of thoracic epidural anesthesia with general anesthesia, while 33 (68.7%) received general anesthesia alone. Patients with epidural anesthesia were found to have significantly lower levels of troponin 12-24 hours after surgery (8.9±4.1 versus 16.8±10.5, p <0.05), while 48 to 72 hours postoperatively, the troponin values of the two groups did not appear to differ (10.7±6.9 vs. 14.8±8.3, p 0.103). Age, sex and body mass index were not found to be significantly associated with the fluctuation of troponin values in this setting.

Conclusion: Patients who undergo open lobectomy receiving a combination of general and thoracic epidural anesthesia appear to maintain lower troponin levels in the immediate postoperative period than patients receiving general anesthesia alone.