Epidural catheter should be inserted compulsorily for all cardiac surgeries and thoracic surgeries—including pediatric cardiac surgeries—for intraoperative and postoperative analgesia. According to the author's clinical experience, epidural catheter insertion at the L2–L3 level, advanced 6–8 cm, provides good intraoperative analgesia and excellent hemodynamic stability in both on-pump and off-pump cardiac surgeries, particularly in high-risk patients.
The author also suggests that, when inserted under strict aseptic precautions with appropriate antibiotic cover, the epidural catheter can be safely maintained for 7–10 days. Potential advantages highlighted include: Good intraoperative analgesia Excellent postoperative pain control Stable intraoperative hemodynamics Reduced opioid requirements Use of cardiac-friendly local anesthetic drugs via the epidural route Earlier ambulation…
