Influence of high epidural block on myocardial contractility in patients with unstable angina

The influence of high thoracic epidural block with Naropin® on the diastolic function of the left ventricle in patients with unstable angina has been studied. The study was performed on the basis of analysis of the results of examination and treatment of 36 patients, men aged 66,3±2,1 years, suffering from coronary heart disease with unstable angina and disturbing diastolic function of the left ventricle. In 24 patients, the left ventricular ejection fraction was lower than 50%. A local anesthetic Naropin® (0,5% solution) was administered epidural at a dose of 50-150 mg per day for 1-7 days before stabilization. The study (Doppler echocardiography) was performed an hour after the epidural blockade. It is proved that epidural blockade improves local and global contractility of the left ventricle, its diastolic function, increases perfusion in the area of stenotic coronary vessels. The revealed properties of epidural blockade allow us to recommend it as an effective means of intensive care for unstable angina.

unstable angina, thoracic epidural block, contractility of the myocardium