Thoracic epidural anesthesia for cardiac surgery

Clearly, there is increasing evidence that TEA is a preferred method of adjunctive anesthesia for cardiac surgery. We have previously published the use of this technique for off pump coronary artery bypass surgery either awake or under general anesthesia. What remains to be seen is if paravertebral blocks can provide similar results with no associated risk of neuraxial hematoma formation. Nonetheless, the risk of hematoma formation appears to be so small that it, alone, should never be the determining factor for not selecting TEA for cardiac surgery.