Epidural sufentanil during paediatric cardiac surgery: effects on metabolic response and postoperative outcome

The metabolic and neuroendocrine effects of caudal epidural analgesia were studied during paediatric cardiac surgery. Combined epidural and general an aesthesia (EPI group; n = 12) was compared with deep opioid anaesthesia (DO A group; n = 12). During anaesthesia and surgery, haemodynamic stability wa s similar in the two groups. There was no significant difference between gr oups concerning the metabolic response to surgery but circulating catechola mines were significantly lower in the EPI group during and after surgery. P erioperative release of IL-6 was higher in the EPI group possibly reflectin g a longer aortic clamp time. Incidence of postoperative life-threatening d ysrhythmias was very low in the two groups. No significant reduction of pos toperative mechanical ventilation, intensive care unit or hospital stays wa s reported with epidural analgesia. The incidence of postoperative infectio ns was higher than expected in the two groups because of the poor properati ve clinical status of most of the children included in the study.