{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:33:56Z","timestamp":1787762036477,"version":"build-2784847793"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>High thoracic epidural anesthesia in cardiac surgery as the sole anesthetic technique is used in a select groups of patients having severe pulmonary co morbidities. We describe a case series of three patients at high risk for post operative pulmonary complications where this technique was used along with dexmedetomidine infusion for conscious sedation in off pump coronary artery bypass grafting. Proper selection of patients, proper placement of the epidural catheter at the appropriate level and timing of catheter insertion and removal are of paramount importance.<\/jats:p>","DOI":"10.4103\/aca.aca_153_22","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T17:40:09Z","timestamp":1689010809000},"page":"321-324","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["High Thoracic Epidural Anesthesia and Dexmedetomidine for Awake Off-Pump Coronary Artery Bypass Grafting: A Feasible Option for Patients with Severe Pulmonary Disease"],"prefix":"10.4103","volume":"26","author":[{"given":"Neeraj K.","family":"Barnwal","sequence":"first","affiliation":[{"name":"Department of Cardiac Anesthesiology, Saifee Hospital and Wockhardt Hospitals, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinil S.","family":"Bhaskar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesiology, Saifee Hospital and Wockhardt Hospitals, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh L.","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Saifee Hospital and Wockhardt Hospitals, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"R1-20240901","first-page":"1075","article-title":"Thoracic epidural anesthesia during coronary artery bypass surgery: Effects on cardiac sympathetic activity, myocardial blood flow andmetabolism, and central hemodynamics","volume":"79","author":"Kirno\u00a8","year":"1994","journal-title":"Anesth Analg"},{"key":"R2-20240901","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1093\/bja\/aem370","article-title":"Coronary artery bypass grafting in the awake patient combining high thoracic epidural and femoral nerve block: First series of 15 patients","volume":"100","author":"Noiseux","year":"2008","journal-title":"Br J Anaesth"},{"key":"R3-20240901","doi-asserted-by":"crossref","first-page":"224","DOI":"10.4103\/0971-9784.69062","article-title":"Thoracic epidural analgesia for off-pump coronary artery bypass surgery in patients with chronic obstructive pulmonary disease","volume":"13","author":"Mehta","year":"2010","journal-title":"Ann Card Anaesth"},{"key":"R4-20240901","first-page":"788","article-title":"Awake coronary artery bypass grafting under thoracic epidural anesthesia: Great impact on off-pump coronary revascularization and fast-track recovery","volume":"40","author":"Watanabe","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"R5-20240901","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/AAP.0000000000000763","article-title":"Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine evidence-based guidelines (fourth edition)","volume":"43","author":"Horlocker","year":"2018","journal-title":"Reg Anesth Pain Med"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_153_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:13:16Z","timestamp":1787760796000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_153_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":5,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_153_22","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2022-09-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}