{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T07:52:26Z","timestamp":1740124346446,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T00:00:00Z","timestamp":1540857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Strategic grants by Karolinska Institutet"},{"name":"County Council of \u00d6sterg\u00f6tland"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Thoracic epidural analgesia (TEDA) was offered to patients with refractory angina pectoris. Our primary objectives were to evaluate TEDAs\u00b4 influence on quality of life (QoL, base for power analysis), and hypothesising that TEDA with bupivacaine during 1 month counteracts exercise\u2010induced myocardial hypoperfusion and increase physical performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with refractory angina and exercise inducible hypoperfusion, as demonstrated by myocardial perfusion imaging (MPI), were randomised to 1\u2010month treatment with TEDA with bupivacaine (B\u2010group, n\u00a0=\u00a09) or saline (P\u2010group, n\u00a0=\u00a010) in a double\u2010blind fashion. MPI and bicycle ergometry were performed before TEDA and after 1\u00a0month while subjective QoL on a visual analogue scale (VAS) reported by the patients was checked weekly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During this month VAS (mean [95%CI]) increased similarly in both groups (B\u2010group from 33 [18\u201050] to 54 [30\u201078] <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05; P\u2010group from 40 [19\u201061] to 48 [25\u201070] <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The B\u2010group reduced their exertional\u2010induced myocardial hypoperfusion (from 32% [12\u201052] to 21% [3\u201039]; n\u00a0=\u00a09; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), while the P\u2010group showed no significant change (before 21% [6\u201035]; at 1\u00a0month 23% [6\u201040]; n\u00a0=\u00a010). MPI at rest did not change and no improvement in physical performance was detected in neither of the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In refractory angina, TEDA with bupivacaine inhibits myocardial ischaemia in contrast to TEDA with saline. Regardless of whether bupivacaine or saline is applied intermittently every day, TEDA during 1\u00a0month improves the quality of life and reduces angina, even when physical performance remains low. A significant placebo effect has to be considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13291","type":"journal-article","created":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T12:32:07Z","timestamp":1540902727000},"page":"515-522","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of thoracic epidural analgesia on exercise\u2010induced myocardial ischaemia in refractory angina pectoris"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9337-3679","authenticated-orcid":false,"given":"Adrian","family":"Gonon","sequence":"first","affiliation":[{"name":"Department of Clinical Science, Intervention &amp; Technology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Clinical Physiology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arina","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Health Link\u00f6ping University Link\u00f6ping Sweden"},{"name":"Link\u00f6ping University Hospital (Heart Centre) Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingemar","family":"Cederholm","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Health Link\u00f6ping University Link\u00f6ping Sweden"},{"name":"Link\u00f6ping University Hospital (Heart Centre) Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jehangir","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Novak","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Department of Clinical Physiology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha","family":"Milovanovic","sequence":"additional","affiliation":[{"name":"Department of Welfare and Care Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitta","family":"Janerot\u2010Sjoberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention &amp; Technology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Clinical Physiology Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Medical Technology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.2706"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2013.200"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2012.01.047"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.06.079"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a059507"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198911000-00002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.81.1.1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199012000-00009"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000154963.29271.36"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/jcan.2002.128419"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-013-0537-z"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199011000-00008"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0026-2862(03)00058-X"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00870.2004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000163551.33812.1A"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32714-9"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.09.538"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/14017430802084997"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2002.3286"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.08.044"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.100784"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03203-7"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faas.13291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T05:05:14Z","timestamp":1694667914000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.13291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,30]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/aas.13291"],"URL":"https:\/\/doi.org\/10.1111\/aas.13291","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"type":"print","value":"0001-5172"},{"type":"electronic","value":"1399-6576"}],"subject":[],"published":{"date-parts":[[2018,10,30]]},"assertion":[{"value":"2018-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}