High epidural thoracic anesthesia for pericardial surgery.

Here are reported three cases involving patients (77, 61 and 58 years-old) with recurrent pericardial effusion who underwent pleuropericardial window using thoracic epidural anesthesia (T1-T2 o T2-T3) while fully awake, without endotracheal intubation. The operative and postoperative courses were uneventful. During the pneumothoracic phase the vital parameters and spontaneous ventilation patterns remained the same compared to the basic ones. Pain control was excellent. On the basis of this early experience the authors conclude that thoracotomy in awake patients to reach the cardiac structures is a reproducible technique.