The use of epidural anesthesia in coronary surgery: pro and contra. Review

Volkov, D.; Paromov, K.V.; Еремеев, А. В.; Kirov, Mikhail Y.

doi:10.21320/1818-474x-2020-2-86-95

Cited by 8 publications

(1 citation statement)

References 85 publications

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“…Regional anesthesia is widely and often used in various fields of medicine, allowing both reducing intraoperative opioid loading and improving the rehabilitation period by creating an anti-inflammatory effect [5,6]. The inability to perform an infraorbital blockade to anesthetize during surgery of the inferior orbital rim wall is associated with the displacements of bone fragments in the infraorbital foramen after the fracture [7].…”

Section: Introductionmentioning

confidence: 99%

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

OP¹,

AV²,

DV³

2022

Act Scie Ortho

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The analgesic effect of the pterygopalatine blockade is successfully used as anesthesia in otolaryngology, with volumetric surgical interventions in the maxillofacial region and as an interventional method for the treatment of migraine, cluster and chronic facial pain, in the treatment of post-functional pain syndrome, postherpetic neuralgia.The purpose of this study is to evaluate the analgesic effect of the infra zygomatic access of performing a pterygopalatine block as a component of combined anesthesia during reconstructive surgery for fractures of the lower orbital edge. Research and Design:The study was carried out at Irkutsk Branch of S. Fyodorov "Eye microsurgery" Federal State Institution of Ministry of Health of the Russian Federation. 9 male patients with the fractures of the lower orbital edge were included.Material and Methods: Pterygopalatine blockade as a component of combined anesthesia was performed through a infrazygomatic access by the impegnation technique for pain management in reconstruction of the inferior orbital rim wall. A 25 mm needle with a 23G diameter was used to anesthetize the pterygopalatine ganglion and the maxillary nerve with solutions of local anesthetics (lidocaine 2% -2 ml and ropivacaine 0.75% -2 ml). The following parameters were evaluated: the adequacy of anesthesia, the duration of the analgesic effect of the pterygopalatine blockade by Verbal Rating Scale, the appointment of additional anesthesia, patient comfort, complications after the blockade.Results: Pterygopalatine blockade as component of a combined anesthesia was effective intraoperatively and didn't cause hemodynamic changes during surgery. During a postoperative period, patients felt comfortable without pain. No additional anesthesia required. The length of the block varied from 4 to 6 hours. Such complications as hemorrhages, intravascular injection of anesthetic, trauma of neural structures were not noticed. Conclusion:Pterygopalatine block is a good alternative to both intra and post operative anesthesia in reposition of the inferior orbital rim wall.

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Section: Introductionmentioning

confidence: 99%

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

OP¹,

AV²,

DV³

2022

Act Scie Ortho

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Responsiveness to Infusion Load under Regional Anesthesia after Off-Pump Coronary Artery Bypass Graft Surgery

Paromov,

Volkov,

Kirov

2023

Obŝaâ reanimatologiâ

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Objective. To evaluate the effect of erector spinae plane block (ESPB) and epidural anesthesia on responsiveness to infusion load after coronary bypass surgery on a beating heart.Materials and methods. A prospective randomized single-center study included 45 patients who were grouped into 3 equal arms based on anesthesia techniques: general anesthesia in combination with ESPB (GA+ESPB), general anesthesia and epidural anesthesia (GA+EA) and general anesthesia without regional techniques (GA). Patient’s response to volume loading was assessed using dynamic and orthostatic tests after transfer from the operating room and at the end of the first postoperative day. Passive leg raise (PLR) and standard bolus injection tests were done at the first stage; changes in hemodynamic parameters during verticalization were additionally evaluated at the second stage. Patients with >10% cardiac index (CI) increase after PLR test and >15% increase after bolus injection test were categorized as responders.Results. The concordance of obtained results in PLR and bolus injection tests for the GA+ESPB, GA+ EA and GA groups at the first stage was 0.53 (95% CI 0.12-0.94), 0.68 (95% CI 0.30-1.00) and 0.61 (CI 0.24-0.99), at the second stage - 0.70 (0.32-1.00), 0.84 (95% CI 0.55-1.00) and 0.82 (95% CI 0.47-1.00), respectively. There were no differences in distribution of responders between the groups. CI dynamics did not differ between the groups during verticalization, and there were no associations of CI changes during verticalization with the preceding PLR test results. The dynamics of troponin T and NT-proBNP did not differ between the groups.Conclusion. Methods of regional anesthesia (SPB or EA) do not significantly affect the responsiveness to infusion therapy in the postoperative period after coronary bypass surgery on a beating heart.

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Influence of high thoracic epidural anesthesia on response to infusion therapy in coronary artery bypass surgery: a prospective randomized controlled trial

Volkov¹,

Paromov²,

Kirov³

2021

Anaes. i reanim.

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The use of epidural anesthesia in coronary surgery: pro and contra. Review

Cited by 8 publications

References 85 publications

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

Responsiveness to Infusion Load under Regional Anesthesia after Off-Pump Coronary Artery Bypass Graft Surgery

Influence of high thoracic epidural anesthesia on response to infusion therapy in coronary artery bypass surgery: a prospective randomized controlled trial

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