Perioperative Effects of Epidural Anesthesia on Hemodynamics, Pain, and Pro-brain Natriuretic Peptide Levels in Vascular Surgery: A Prospective Randomized Study

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Sivacigil M. I., Sivacigil L., YÜCEYAR L., Erolcay H.

Haseki Tip Bulteni, cilt.64, sa.2, ss.92-100, 2026 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 64 Sayı: 2
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/haseki.galenos.2026.97269
  • Dergi Adı: Haseki Tip Bulteni
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Sayfa Sayıları: ss.92-100
  • Anahtar Kelimeler: Anesthesia, epidural, vascular surgical procedures, natriuretic peptide, brain, Troponin I, postoperative pain
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Aim: Vascular surgery is among the surgical procedures associated with the highest cardiac morbidity and mortality because the surgical stress response is pronounced in individuals with cardiogenic risk factors. The aim of this study is to evaluate the effect of epidural anesthesia on the surgical stress response during major vascular surgery. Methods: Two groups (epidural group (EG), n=15; control group, n=15) were formed in the cardiovascular surgery operating room by prospective randomization. Hemodynamic fluctuations and visual analog scale (VAS) pain scores were monitored. The primary endpoint was defined as the change in N-terminal-proBNP (NT-proBNP) levels on postoperative day two compared with preoperative measurements. Troponin-I, changes in blood flow, pain scores, and sevoflurane use were secondary endpoints. Results: Sevoflurane consumption was lower in EG, whereas fluid volume was higher. ≥11 tachycardia attacks were more frequent in CG, and ≥11 decreases in mean arterial pressure were seen (33.3% vs. 0%; p=0.042). VAS was lower in favor of EG (Day-1: 4.33±0.98 vs. 5.27±0.70, p=0.011; Day-2: 1.67±1.13 vs. 2.13±0.64, p=0.041). No difference in NT-proBNP/troponin-I levels was observed between groups. Conclusion: In vascular surgery, epidural anesthesia can reduce hemodynamic fluctuations and early postoperative pain while limiting the rise in NT-proBNP. Biomarker findings are hypothesis-generating owing to methodological constraints and necessitate validation through studies with larger sample sizes.