High thoracic epidural analgesia in cardiac surgery. Part 2--high thoracic epidural analgesia does not reduce time in or improve quality of recovery in the intensive care unit.

OBJECTIVE: To evaluate the postoperative effect of high thoracic epidural analgesia on the time in the intensive care unit (ICU) and the quality of cardiac recovery in patients undergoing cardiac surgery. DESIGN: A randomized prospective study. PARTICIPANTS: Sixty low-risk patients 65 to 80 years of age scheduled for elective coronary artery bypass graft surgery with or without aortic valve replacement. SETTING: A university hospital. INTERVENTIONS: Patients randomized to receive high thoracic epidural analgesia (HTEA) as a supplement to general anesthesia. MEASUREMENTS AND MAIN RESULTS: The eligible time to discharge from the ICU and the quality of recovery were evaluated by an objective ICU scoring system. The time to eligible discharge from the ICU, the ventilation time, and the actual time in the ICU were not shorter in the HTEA group compared with patients receiving conventional general anesthesia. Patients receiving HTEA in addition to general anesthesia received less morphine postoperatively but with no consequent beneficial effect on respiration, nausea, sedation, or motor function. CONCLUSIONS: HTEA does not reduce the time in the ICU or improve the quality of recovery in the ICU.