Objective:To assess the therapeutic effects of cardiac sympathelicblockade in coronary heart disease(CHD),acute myocardial infarction(AMI),andperioperative cardisc protection.Material and Method:In a series or CHD and AMIpatients treated in this hospital,thoracic epidural ansigesin(TEA)at T1-5 wasperformed by epidural bolus injection of 5-8 ml of 0.5-0.75% lidocaire every 2 to 4houra,with the duration and number of TEA trastment course suited to patient’scondition.Result:In 48 cases of angina pectoris with a score of 95—100 and in 12cnses of angina pectoris with a score of 80～94.the post-TEA scorc becamezero(completely painless);other pre-and post-TEA data ineluded NST-T3.1±1.0.p0.01).∑ ST-T(2.89±0.9 vs.1.8±0.8,p0.01),le ventricular(I.V)diastolic performance(E/A 0.89±0.4 vs.1.04±0.37,p0.02;E penk 57.41±15.18 vs.66.35±13.73,p0.02),LV systolic performance(SV 48.79±19.42 vs.67.2±15.8.p0.01;CO 3.97±1.3 vs.5.4±0.86,p0.05;EF 58.04±10.28 vs 69.7±8.92.p 0.02).Inpatlienls with angina pectcris and head failure,pre-and post-TEA compnrisonsincluded ANP(324.57±227.6 vs.104.67±107,46.p0.02)and Q-T cd(63.7±30.8 vs.45.6±25.7,p0.05).In patients with AMI.the serum free fatty acids(FFA)levellowered from 1310±233(wEq/L)on admission to 456±72 at 12h after TEA,inomparison(p0.05)with 1491±524 to 1383±532 in the control group without use ofTEA;pump failure incidence of the TEA and control groups was in a ratio of 1 to 9;and arrhythmia incidence of the TEA and control grouns was in a ratio of 2 to 11.Ahundred perioperative patienta with CHD used TEA.and among them no deathoccurred,ventricular arrhythmias and atrial prernalure heals disappeared.Conclusion:Thocic epidural anslgesin(TEA)at T1～5 is significantly effective for:preventionand treatment of angina pectoris;emergency prevention of AMJ by combined use ofTEA and heparin;improvement of diastolic and systolic functions in CHD;prevtionof pump failurc and atrhythmias in AMI;and perioperative cardiac protion ofpatients with CHD.
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