Cardiac sympathetic blockade with high-thoracic epidural anesthesia is considered
beneficial in patients undergoing major surgery because it offers protection in ischemic heart
disease. Major outcome studies have failed to confirm such a benefit, however. In fact, there
is growing concern about potential harm associated with the use of thoracic epidural
anesthesia in high-risk patients, although underlying mechanisms have not been identified.
Since the latest review on this subject, a number of clinical and experimental studies have …