Односторонняя Субарахноидальная Блокада Для Интраоперационного Обезболивания Пластики Пахового Канала

Byshovets, S.M.; Dzuba, D.O.

doi:10.22141/2224-0586.16.2.2020.203141

ЕМ

2021

DOI: 10.22141/2224-0586.16.2.2020.203141

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Односторонняя Субарахноидальная Блокада Для Интраоперационного Обезболивания Пластики Пахового Канала

S.M. Byshovets¹,

D.O. Dzuba²

Abstract: II за ASA) проведено двобічну субарахноїдальну блокаду (ДСБ) 15 мг ізобаричного бупівакаїну у поєднанні з 0,06 мг бупренорфіну при аналогічній операції. ОСБ і ДСБ ефективно забезпечували знеболювання операцій і тривалу післяопераційну аналгезію. При ОСБ гемодинаміка була стабільною внаслідок застосування однобічного, а не двобічного симпатичного блоку на відміну від ДСБ. Покращення якості аналгезії дозволяло проводити ранні активізацію та ентеральне харчування пацієнтів і скорочувало період реабілітації. Субар… Show more

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Spinal anesthesia during foot surgery

Gritsenko

Filimonova

Filimonov

2021

Modern Medical Technology

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Purpose of the study. To improve the results of treatment of patients with diabetic foot syndrome by substantiating the optimal type of spinal anesthesia during foot surgery. Materials and methods. 70 patients undergoing treatment in the department of purulent surgery were examined. Patient groups: Group 1 – patients operated on under conditions of unilateral spinal anesthesia; Group 2 – patients operated on under traditional spinal anesthesia. Research methods. Assessment of the level and intensity of pain, concentration of catecholamines in urine in the first postoperative day, monitoring of blood pressure (BP), heart rate (HR), peripheral blood oxygen saturation (SpO2), Doppler scanning of peripheral blood flow in the foot, skin temperature integument of the foot during anesthesia and statistical. Results. In group 1, pain sensitivity during movement of the lower limb after anesthesia was 21% less pronounced than in group 2. In group 2, the heart rate decreased by 4,8% during anesthesia. The SpO2 level 20 minutes after the onset of anesthesia decreased in group 2 by 5,1% compared to group 1. The mean arterial pressure in group 2 decreased during anesthesia by 9,9%, in contrast to patients in group 1. After performing anesthesia, systolic blood pressure in the toe increased by 18,3%, and the temperature of the skin on the lateral surface of the leg increased by 3,7%. The concentration of adrenaline in the daily portion of urine in the next postoperative day in group 2 is 35,1% higher than in group 1. Conclusions. During anesthesia, the blood pressure, heart rate and SpO2 in group 1 did not change in comparison with the initial values (on the operating table before anesthesia). After anesthesia, an improvement in peripheral blood flow in the operated limb was noted. Unilateral spinal anesthesia, in comparison with traditional spinal anesthesia, has a positive effect on the stress response of the patient's body to surgery.

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Spinal anesthesia during foot surgery

Gritsenko

Filimonova

Filimonov

2021

Modern Medical Technology

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Unilateral spinal anesthesia and the sciatic nerve block in foot surgery

Gritsenko

Shapoval

Filimonov

2021

Modern Medical Technology

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Purpose of the study. To evaluate the effectiveness of unilateral spinal anesthesia as a method of pain relief during foot surgery. Analyze the effectiveness of unilateral spinal anesthesia versus sciatic nerve block. To develop an algorithm for performing unilateral spinal anesthesia during foot surgery. Materials and methods. We examined 64 patients who were treated in the department of purulent surgery of the 3rd city hospital in Zaporozhye with a diagnosis of diabetic foot syndrome in the period from 2017 to 2019. Research methods. Assessment of the level of pain intensity using the standard visual analogue scale and the concentration of glucose in the blood serum. Monitoring of the parameters of the cardiovascular system, the temperature of the skin of the lower leg during anesthesia, Doppler scanning of the peripheral circulation in the foot. Results. 4 hours after performing anesthesia, the intensity of pain during movement of the lower limb, according to the visual analogue scale in the group with unilateral spinal anesthesia was 2,3 times less than in the group with sciatic nerve block (p < 0,05). After 10 hours – in the sciatic nerve block group there was a 9,4% increase in comparison with the unilateral spinal anesthesia group (p < 0,05). Compared with the unilateral spinal anesthesia group, in the sciatic nerve block group 20 minutes after anesthesia, the heart rate decreased by 7,2% (p < 0,05). After unilateral spinal anesthesia, the level of systolic blood pressure on 1 toe of the foot increased by 18,3% 20 minutes after anesthesia, and 20 minutes after sciatic nerve block – by 13,7% (p < 0,05). In patients with the unilateral spinal anesthesia group, the temperature on the operated lower limb after anesthesia increased by 3,8%, in the sciatic nerve block group – by 2,8% (p < 0,05). Conclusions. Regional anesthesia is the main method of choice for foot surgery compared to general anesthesia. sciatic nerve block does not in all cases lead to 100% surgical anesthesia and requires additional medical analgosedation. For foot surgery, unilateral spinal anesthesia is preferred.

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Односторонняя Субарахноидальная Блокада Для Интраоперационного Обезболивания Пластики Пахового Канала

Cited by 2 publications

References 7 publications

Spinal anesthesia during foot surgery

Spinal anesthesia during foot surgery

Unilateral spinal anesthesia and the sciatic nerve block in foot surgery

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