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Easing Heartache

13 years, 7 months ago

1216  0
Posted on Jul 06, 2005, 8 a.m. By Bill Freeman

Many people associate epidurals with childbirth. But, this type of pain prevention has other uses. The University of Chicago Hospitals is one of the few in the country now using epidurals for heart surgery. The belief is this local anesthesia reduces dangerous stress and helps patients get on their feet faster. But it's not without risks.

His pace may be slow, but Jim Dingfelder's recovery is remarkably fast considering he just had open heart surgery.

"The first day you are up walking around and out of bed," said Jim Dingfelder, heart patient.

Jim and his wife traveled from Chapel Hill, North Carolina, to the University of Chicago Hospitals because it is one of the few institutions doing this. This is a thoracic epidural or high epidural. It is the key to so-called "painless cardiac surgery". Through a catheter, anesthesia is delivered into the upper portion of the spine. It is put in a day before the operation, and it stays in several days after.

LaVerne Morain got the epidural before having heart valve surgery.

"Nothing to it. It was a couple of little sticks and didn't amount to anything. It was totally painless," said LaVerne Morain, heart patient.

Patients still get general anesthesia during the operation. It makes them unconscious, but it does nothing for the brain. That's what the epidural is for. Because the anesthesia is delivered directly to the nerves in the spine, pain signals that would normally go to the brain are blocked.

"An epidural or yoga therapy for instance is a relaxer, and when it relaxes, the blood vessels automatically dilate and you get more blood flow to the heart," said Dr. Valluvan Jeevanandam heart surgeon, University of Chicago Hospitals.

Surgeons and anesthesiologists say increased blood flow keeps the heart healthier. That is the first benefit. Research also shows patients on the epidural need about 75 percent less anesthesia and narcotic medication.

They wake from surgery faster, with less grogginess, and in many cases they feel no pain.

"Most of the patients say they wake up waiting for pain, and they wait for a while, and they don't have any pain, and they are just waiting for the hammer to fall, so to speak, and they are kind of surprised," said Dr. Patricia Grambling-Babb, anesthesiologist, University of Chicago Hospitals.

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