Общая реаниматология (Apr 2011)
Hemodynamics and Blood Oxygen-Transport Function under Combined Anesthesia with Preserved Spontaneous Respiration
Abstract
Objective: to improve the results of surgical treatment, by ruling out the negative effects of mechanical ventilation (MV) via combined anesthesia without myoplegia during operations on the lower abdomen. Subjects and methods. One hundred and twenty-one patients aged 20 to 64 years were examined. The patients were divided into 2 groups: 1) inhalation anesthesia under total myoplegia and continuous MV; 2) inhalation anesthesia without myoplegia and with preserved spontaneous respiration or pressure-support MV (PSMV). Results. The procedure of the latter allows combined anesthesia with preserved spontaneous respiration during operations on the lower abdomen and great vessels to have inadequate transport of oxygen under its relatively increased uptake in 98% of patients without any risk. MV made to prosthelytize external respiration function under combined anesthesia and total myoplegia causes a decrease in cardiac index (CI) by 40% or more (p<0.05) and increases in total peripheral vascular resistance (TPVR) by 50% or more (p<0.05) and intrapulmonary shunt by 3 times (p<0.05). Combined anesthesia without myoplegia and MV prevent induced changes in CI, TPVR, and Qs/Qt. The differences are significant throughout the follow-up (an intraoperative step and 9 postoperative hours). Conclusion. To rule out myoplegia and MV during combined anesthesia prevents MV-induced changes in CI, TPVR, and Qs/Qt. Key words: combined anesthesia, spontaneous respiration, hemodynamics, blood oxygen-transport function.