Novosti
|
This journal is indexed in Scopus |
|---|
Year 2011 Vol. 19 No 5
ANESTHESIOLOGY-REANIMATOLOGY
P.A. LYUBOSHEVSKY, A.M. OVECHKIN, A.V. ZABUSOV
THE ROLE OF EPIDURAL ANAESTHESIA IN LIMITATION OF PERIOPERATIVE HAEMOSTASIS DISTURBANCES AT ABDOMINAL SURGERIES
Objectives. To estimate haemostasis system changes at the abdominal surgeries depending on an anesthesia method.
Methods. 140 patients undergone the scheduled upper- abdominal surgeries were included into the research. Patients were allocated into two groups: only total intravenous anesthesia (n=70) or general anesthesia combined with epidural analgesia (n=70). The quality of postoperative pain relief, concentrations of glucose and cortisol, coagulation and platelets aggregation indexes were investigated. The frequency of hemotransfusions and complications connected with haemostasis disturbances were also analyzed.
Results. It was established that epidural anesthesia and analgesia provided more adequate postoperative pain relief and limited increase of glucose and cortisol concentration during and after surgery. In both groups activation of coagulation and platelet aggregation with acceleration of fibrinolysis was marked. These changes were significantly less marked at epidural group. Frequency of blood transfusions at epidural anesthesia was lower and this probably is connected with restriction of fibrinolysis activation.
Conclusions. Epidural anesthesia at the upper-abdominal surgeries limits changes of haemostasis and reduces requirement for blood transfusions
- Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials / A. Rodgers [et al.] // British Medical Journal. – 2000. – Vol. 321. – P. 1493-1497.
- Овечкин, А. М. Спинальная и эпидуральная анестезия в хирургии: клиническое значение и влияние на исход лечения / А. М. Овечкин // Регионарная анестезия и лечение острой боли. – 2006. – Т. 1, № 1. – С. 16-24.
- Небылицин, Ю. С. Диагностика тромбоза глубоких вен нижних конечностей / Ю. С. Небылицин, С. А. Сушков // Новости хирургии. – 2007. – № 3. – С. 45-56.
- Коррекция фибринолитического варианта ДВС-синдрома в раннем послеоперационном периоде / С. В. Синьков [и др.] // Общая реаниматология. – 2007. – Т. 3, № 1. – С. 78-81.
- Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery / O. Ahlers [et al.] // British Journal of Anaesthesia. – 2008. – Vol. 101, N 6. – P. 781-787.
- Влияние анестезии и антикоагулянтной профилактики на возникновение послеоперационных тромбоэмболических осложнений у ортопедических больных / М. И. Неймарк [и др.] // Анестезиология и реаниматология. – 2006. – № 2. – С. 35-38.
- Effects of epidural-and-general anesthesia combined versus general anesthesia alone on the venous hemodynamics of the lower limb. A randomized study / K. T. Delis [et al.] // Thrombosis & Haemostasis. – 2004. – Vol. 92, N 5. – P. 1003-1011.
- Epidural anesthesia prevents hypercoagulation in patients undergoing major orthopedic surgery / M. W. Hollmann [et al.] // Regional Anesthesia and Pain Medicine. – 2001. – Vol. 26, N 3. – P. 215-222.
- The effects of local anesthetics on perioperative coagulation, inflammation, and microcirculation / K. Hahnenkamp [et al.] // Anesthesia & Analgesia. – 2002. – Vol. 94. – P. 1441-1147.
- Роль спинально-эпидуральной анестезии в профилактике интраоперационной кровопотери при операциях на брюшном отделе аорты / С. И. Ситкин [и др.] // Регионарная анестезия и лечение боли: сб. науч. ст. / под ред. А. М. Овечкина, С. И. Ситкина. – Тверь: Триада, 2004. – С. 210-213.
- Загреков, В. И. Влияние уровня артериального давления на кровопотерю при операции эндопротезирования тазобедренного сустава / В. И. Загреков, И. Ю. Ежов // Новости хирургии. – 2010. – Т. 18, № 4. – С. 82-90.
Article in the .pdf format
