ASSESSMENT OF THE QUALITY OF INTRAOPERATIVE ANALGESIA IN CONDITIONS OF MIXED AND COMBINED ANESTHESIA IN PATIENTS THORACOCERVICAL PROFILE

Abstract

The qualitative choice of anesthesia affects not only the effectiveness of intraoperative analgesia, but also the patient's condition and quality of life during the entire intraoperative and postoperative period. The aim of the work was to identify the features of combined and combined anesthesia in surgical interventions of the thoracic profile. The first group consisted of patients (n=17), whose surgical intervention was accompanied by combined anesthesia, and patients of the second group (n=23) - under combined anesthesia. The following parameters were evaluated: blood pressure, heart rate, volume of infusion therapy, additional administration of vasopressors, additional doses of analgesics. The induction was carried out with fentanyl 5 mg / kg, propofol 2 mg / kg, rocuronium 0.6 mg / kg. Maintenance anesthesia was performed with sevoflurane up to 1.1 MAC. Also, when using combined anesthesia, ropivacaine 0.75% - 10.0 ml was used. Statistical analysis was performed by the STATISTICA 10.0 software. The study did not reveal statistically significant differences in analgesic intraoperative protection in both methods of analgesia. Both methods provide an adequate and high-quality level of intraoperative protection, and also do not have a significant negative impact on the course of the intraoperative and early postoperative periods.

Full Text

Relevance of the study: qualitative choice of the anesthesia method reflects the success of effective adequate analgesic protection of the patient in the intraoperative period [1, 2].

The purpose of the study: to identify the features of combined or combined anesthesia in surgical interventions of the thoracic profile.

Materials and methods: a retrospective analysis of the anesthesia records of 40 patients who underwent lung lobectomy was performed. The median age was 63.5 ± 7.52 years. The first group consisted of patients (n = 17), whose operation was accompanied by combined anesthesia, patients of the second group (n = 23) - under combined anesthesia. The induction was carried out with fentanyl 5 mg / kg, propofol 2 mg / kg, rocuronium 0.6 mg / kg. Maintenance anesthesia was performed with sevoflurane up to 1.1 MAC. Also, when using combined anesthesia, ropivacaine 0.75% - 10.0 ml was used. The following parameters were evaluated: blood pressure (BP), heart rate (HR), volume of infusion therapy, administration of vasopressors, additional doses of analgesics. Statistical analysis was performed by the STATISTICA 10.0 software.

Results and discussion: in the first group, under combined anesthesia, the heart rate was 78.1 ± 10.7 beats / min; ADp 115.4 ± 12.3 mmHg; ADp 72.7 ± 7.8 mmHg. In the second group, under combined anesthesia, the heart rate was 83.8 ± 8.7 beats / min; the ADp was 118.3 ± 13.1 mmHg; the ADp was 74.6 ± 13.4 mmHg. The infusion of crystalloid solutions in the first group was 1083.2±545.6 ml; in the second group – 1025.2±438.1 ml. Infusion of colloidal solutions: in the group of combined anesthesia-534.8±235.2 ml; in the group of combined anesthesia-402.1±5.3 ml. Additional analgesia in the first group was 176.0 ± 93.4 µg; in the second – 116.3±38.5 micrograms. There were no statistically significant differences between the groups among these indicators (U-Cr-p≥0.05).

Conclusions: the study did not reveal statistically significant differences in analgesic intraoperative protection in patients with combined and combined anesthesia. This proves that both methods provide an adequate and high-quality level of intraoperative protection in thoracic surgical interventions.