The Influence of Peripheral Chemoreflex Sensitivity on the Critical Incidents Rate During Combined Anesthesia

Abstract

Aim. The goal of the study was to assess the impact of peripheral chemoreflex sensitivity on the rate of critical incidents in extensive abdominal operations.Materials and methods. The study included 176 patients who underwent major abdominal surgery under combined anesthesia. On the eve of surgery, sensitivity of peripheral chemoreflex was determined in all subjects. Sex, age, initial physical status, cardiovascular risk were also registered. During anesthesia hemodynamic, respiratory and metabolic critical incidents were registered.Results. In total, 158 critical incidents were observed. They were significantly more common in patients with high sensitivity to peripheral chemoreflex (72% vs. 48%, p<0.05). The structure of critical incidents was dominated by hemodynamic, primarily hypotension, and its frequency was 2 times higher among patients with high sensitivity of peripheral chemoreflex.The logistic regression showed that factors associated with the risk of critical incidents are high sensitivity of peripheral chemoreflex, increased age, and initially high grade of ASA scale.Conclusion. Hemodynamic incidents are the most common in major abdominal surgery; risk factors for their development are high sensitivity of peripheral chemoreflex, increased age and deterioration of the initial physical status.