Perioperative prevention of cardiovascular complications in patients with atherosclerotic lesions of the infrarenal aorta

Abstract

The study involved 237 patients aged 54 to 69 years who underwent aorto-bifemoral bypass surgery due to the atherosclerosis of aorta and its branches. Depending on a method of the anesthesia, patients were divided into 3 groups: in 1st group NLA was used, in the 2nd - epidural anesthesia at ThXII-LI with mechanical ventilation and in the 3rd - thoracic epidural anesthesia at ThX-ThXI with mechanical ventilation. The patient groups were representative. The most high and stable rates of coronary blood flow and central hemodynamics were in patients with thoracic epidural anesthesia (ThX-ThXI) with mechanical ventilation, due to the small doses of local anesthetic combined with a narcotic analgesic. Blockade of the sympathetic trunk has provided the most high and stable parameters of coronary flow, stroke output index and cardiac output fraction compared with other groups of patients.

Keywords

• торакальная эпидуральная анестезия
• атеросклероз аорты и ее ветвей
• коронарный кровоток
• наведенные кожные вегетативные потенциалы