Email this article THE LIMITATION OF METABOLIC AND INFLAMMATORY ALTERATIONS IN POST-SURGERY PERIOD: THE ROLE OF FIELD BLOCK ANESTHESIA AND ANALGESIA
- Authors: Lyuboshevskiy P.A1, Zabusov A.V1, Timoshenko A.L1, Korovkin D.V1
-
Affiliations:
- The Yaroslavl state medical academy of Minzdrav of Russia
- Issue: Vol 19, No 5 (2013)
- Pages: 15-19
- Section: Articles
- URL: https://bakhtiniada.ru/0869-2106/article/view/38131
- DOI: https://doi.org/10.17816/rmj38131
- ID: 38131
Cite item
Full Text
Abstract
The limitation of surgery stress-response is considered as one the main tasks of anesthesia and post-surgery intensive therapy. The article deals with evaluation of intensity of neuro-endocrinal, metabolic and inflammatory alterations after abdominal operations depending on type of anesthesia. The sample of 260 patients was divided on groups depending on type of anesthesia (total intravenous anesthesia as is, combined with epidural or spinal anesthesia). The analysis was applied to concentration of cortisol, glucose, lactate, cytokines, nitrogen excretion with urine and intensity of post-surgery pain syndrome. During post-surgery period significant increase of concentration of cortisol, glucose and lactate and pro inflammatory and antiinflammatory cytokines was established. The application of both spinal and epidural anesthesia during operation significantly decreased intensity of these alterations and limited nitrogen excretion. Besides, the epidural analgesia provided more adequate post-surgery pain relief.
Full Text
##article.viewOnOriginalSite##About the authors
P. A Lyuboshevskiy
The Yaroslavl state medical academy of Minzdrav of Russia
Email: pal_ysma@mail.ru
150000, Ярославль, Россия
A. V Zabusov
The Yaroslavl state medical academy of Minzdrav of Russia150000, Ярославль, Россия
A. L Timoshenko
The Yaroslavl state medical academy of Minzdrav of Russia150000, Ярославль, Россия
D. V Korovkin
The Yaroslavl state medical academy of Minzdrav of Russia150000, Ярославль, Россия
References
- Kehlet H., Holte K. Effect of postoperative analgesia on surgical outcome. Br. J. Anaesth. 2001; 87 (1): 62—72.
- Desborough J.P. The stress response to trauma and surgery. Br. J. Anaesth. 2000; 85 (1): 109—17.
- Овечкин А.М. Хирургический стресс-ответ, его патофизиологическая значимость и способы модуляции. Регионарная анестезия и лечение острой боли. 2008; 2 (2): 49—62.
- White P.F., Kehlet H., Neal J.M. et al. The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesth. Analg. 2007; 104: 1380—96.
- Milner E.A., Cioffi W.G., Mason A.D. et al. Accuracy of urinary urea nitrogen for predicting total urinary nitrogen in thermally injured patients. J. Parenter. Enteral Nutr. 1993; 17: 414—6.
- Ahlers O., Nachtigall I., Lenze J. et al. Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery. Br. J. Anaesth. 2008; 101 (6): 781—7.
- Volk T., Schenk M., Voigt K. et al. Postoperative epidural anesthesia preserves lymphocyte, but not monocyte, immune function after major spine surgery. Anesth. Analg. 2004; 98: 1086—92.
- Hollmann M.W., Durieux M.E. Local anesthetics and the inflammatory response: a new therapeutic indication? Anesthesiology. 2000; 93 (3): 858—75.
- Webster J., Barnard M., Carli F Metabolic response to colonic surgery: extradural vs continuous spinal. Br. J. Anaesth. 1991; 67 (4): 467—9.
- de Oliveira G.S., Ahmad S., Schink J.C. et al. Intraoperative neuraxial anesthesia but not postoperative neuraxial analgesia is associated with increased relapse-free survival inovarian cancer patients after primary cytoreductive surgery. Regional Anesth. Pain Med. 2011; 36 (3): 271—7.
Supplementary files
