Novosti
Khirurgii
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Year 2010 Vol. 18 No 3

ANESTHESIOLOGY-REANIMATOLOGY

LYUBOSHEVSKY P.A., ZABUSOV A.V.

REGIONAL ANAESTHESIA IN THE PREVENTIVE MAINTENANCE OF THE POSTOPERATIVE RESPIRATORY DYSFUNCTION IN THE ABDOMINAL SURGERY

Objectives: To estimate the postoperative respiratory dysfunction after the abdominal surgery depending on the kind of anesthesia, analgesia and operation area.
Methods. 195 patients scheduled to undergo the abdominal surgeries of high traumatism have been investigated. In the upper-abdominal group 45 patients were allocated to receive either general anesthesia alone; in 45 other patients the general anesthesia combined with epidural analgesia. In lower-abdominal group 35 patients received general anesthesia alone, 35 patients received general anesthesia combined with epidural analgesia and 35 general anesthesia combined with spinal anesthesia. We investigated the course of anesthesia and the period of postanaesthesia adaptation, postoperative pain relief, spirometric parameters, and arterial blood gases.
Results. Use of both kinds of regional anesthesia led to the decrease in the charge of anesthesia medications that was accompanied by faster postanaesthesia adaptation and restoration of spontaneous breath. The pain relief was considerably better among patients receiving epidural analgesia. In all groups decrease in spirometric parameters was noted, it was more expressed after upper-abdominal surgery. Epidural analgesia improved spirometric parameters both after upper-abdominal, and after lower-abdominal surgeries. In upper-abdominal group it also improved oxygenation. Spinal anaesthesia accelerated postanaesthesia adaptation, but did not influence postoperative pain, spirometric parameters and gas exchange. Frequency of a postoperative pneumonia was lower among the patients receiving regional anaesthesia.
Conclusion. Continuous epidural analgesia significantly reduces respiratory dysfunction in major abdominal surgery.

Keywords: abdominal surgery, regional anesthesia and analgesia, respiratory dysfunction
p. 120 128 of the original issue
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