64 -3 (31/2) 2020 — Gaziev Z.T., Avakov V.E. – NEUROAXIAL ANESTHESIA DURING THE OPERATIONS OF REPLACEMENT OF LARGE JOINTS

NEUROAXIAL ANESTHESIA DURING THE OPERATIONS OF REPLACEMENT OF LARGE JOINTS

Gaziev Z.T. -Tashkent Medical Academy.

Avakov V.E. -Tashkent Medical Academy.

Resume

Objective: to study hemodynamic changes and complications, the effectiveness and safety of unilateral and combined spinal-epidural anesthesia in orthopedic patients who have undergone endoprosthetics of lower limb joints in old age.

Materials and methods: Studies were performed in 40 patients of geriatric age operated on under conditions of combined spinal-epidural anesthesia. 29 patients underwent total hip arthroplasty (THA), 11 – total knee arthroplasty (TKA). Inclusion criteria: elderly (from 65 to 75 years) and senile (76-90 years) age, and over 90 – long-livers, pain syndrome more than one year, lack of contraindications for regional methods of pain relief. For continuous monitoring of the vital functions of the patient, they used the “resuscitation and surgical” monitor UM 300 (LLC UTAS Company Ukraine).

Conclusion: The technique of unilateral spinal and epidural anesthesia with small doses of intrathecal local anesthetic (5 mg of a 0.5% hyperbaric solution of bupivacaine with 20 mg of fentanyl) and the addition of low doses of 7.5 mg of bupivacaine into the epidural space allows for proper sensory-motor block, necessary for joint arthroplasty of the lower extremities.

Key words: spinal-epidural anesthesia, central and peripheral hemodynamics, joint replacement of the lower extremities.

First page

269

Last page

274

For citation: Gaziev Z.T., Avakov V.E., Neuroaxial anesthesia during the operations of replacement of large joints//New Day in Madicine 3(31)2020 269-274 https://cutt.ly/rxOR06T

List of References

1. Бессонов С.В. Особенности анестезиологического обеспече­ния эндопротезирования крупных суставов нижних конечно­стей. С.В. Бессонов, А.К Орлецкий, В.Л Кассиль. Вестник Травмвтологии и Ортопедии им. Н.Н Приорова. 2005; 1:85-90.
2. Загреков В.И. Влияние метода обезболивания на кровопотерю при эндопротезировании тазобедренного сустава. В.И Загре­ков (и др). Медицинский альманах. 2010; 2 (11); 210-212.
3. Обухов В.А. Выбор метода обезболивания при протезирова­нии тазобедренного сустава. В.А. Обухов и др. XI. В серос.кон- г.анестезиологов и реаниматологов: сб. материалов. Спб., 2008;235-236.
4. Овечкин А.М. Профилактика послеоперационного болево­го синдрома: патогенетические основы и клиническое при­меyеyие: автореферат дисс. д-ра мед. yаук. Овечкиy А.М.2000; 43 с.
5. Плаxотина Е.Н. Периоперационное лечение пациентов пожилого и старческого возраста с дегенеративно-дистрофическими заболеваниями (эксперим-клинич. иссёед. Автореферат дисс….д-ра мед. наук:14.00.37. Псаxотина Е.Н. СПбМА- ПО.СПб.2009. 42 с.67.
6. Chakladar A, White SM. Cost estimates of spinal versus general anesthesia for fractured neck of femur surgery. Anasthesia 2010 aug 65(8):810-4 epub 2010 may 27/
7. Matteu T. Continuous femoral nerve block: varying local anesthetic delivery method (bolus versus basal) to minimize quadriceps motor block while maintaining sensory block/ T. Matteu (et al). Anesth 2011: 115(4): 774-781.
8. Pugely AJ, Martin CT, Gao y, Mendozza-Lattes S, Callaghan JJ. Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty. J Bone Joint Surg Am. 2013 feb 6:95(3):193-9 Epub 2012 dec 28.
9. Scarecrows AJ, Martin KT, Gao J, Mendozza-Lattes S, Callaghan JJ. Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty. J Bone Joint Surg Am. 2013 feb 6:95(3):193-9 Epub 2012 dec 28th (PubMed) (goole scholar).
10. Sheferf R, Eberherda M (2009) Анесиестезиоёогия (Anesthesiology). Moscow: Geotar-Media.
11. Willburger R.E Medical and cost efficiency of autologous blood donation in total hip or knee replacement/R.E.Willburger, et al. Orthop. Ihre Grenzgeb 2005: 143 (3): 360-364.

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