Association of thoracic epidural analgesia with risk of atrial arrhythmias after pulmonary resection: a retrospective cohort study

Ryu Komatsu, Natalya Makarova, Jarrod E. Dalton, Zhuo Sun, Dennis Chang, Radhika Grandhe, Roshni Sreedharan, Karine De Oliveira Dias, Rakhi Pal, Allen Bashour, Sudish C. Murthy, Alparslan Turan

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Methods: We evaluated patients who had pulmonary resection. New-onset atrial arrhythmias detected before hospital discharge was our primary outcome. Secondary outcomes included other cardiovascular complications, pulmonary complications, time-weighted average pain score over 72 h, and duration of hospitalization. Patients with combination of general anesthesia and TEA were matched on propensity scores with patients given general anesthesia only. The matched groups were compared by use of logistic regression, linear regression, or Cox proportional hazards regression, as appropriate.

Results: Among 1,236 patients who had pulmonary resections, 937 received a combination of general anesthesia and TEA (TEA) and 299 received general anesthesia only (non-TEA). We successfully matched 311 TEA patients with 132 non-TEA patients. We did not find a significant association between TEA and postoperative atrial arrhythmia (odds ratio (95 % CI) of 1.05 (0.50, 2.19), P = 0.9). TEA was not significantly associated with length of hospital stay or postoperative pulmonary complications (odds ratio (95 % CI) of 0.71 (0.22, 2.29), P = 0.47). TEA patients experienced fewer postoperative cardiovascular complications; although the association was not statistically significant (odds ratio (95 % CI) of 0.30 (0.06, 1.45), P = 0.06). Time-weighted average pain scores were similar in the two groups.

Conclusion: TEA was not associated with reduced occurrence of postoperative atrial arrhythmia. Although postoperative pulmonary complications were similar with and without TEA, TEA patients tended to experience fewer cardiovascular complications.

Purpose: Atrial arrhythmias are common after non-cardiac thoracic surgery. We tested the hypothesis that TEA reduces the risk of new-onset atrial arrhythmias after pulmonary resection.

Original languageEnglish (US)
Pages (from-to)47-55
Number of pages9
JournalJournal of Anesthesia
Issue number1
StatePublished - Feb 2014
Externally publishedYes


  • Atrial arrhythmias
  • Epidural anesthesia
  • Pulmonary resection

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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