[Epidural anesthesia in surgical interventions on the spine and spinal cord. I. Comparative analysis of the effectiveness of anesthesiological protection under conditions of epidural anesthesia and neuroleptanalgesia in surgery of the spine and and spinal cord].
The study was carried out in 22 patients operated on for vertebral disk hernias and spinal tumors at lumbosacral level. The patients were divided in 2 groups depending on the type of anesthesia (epidural or neuroleptanalgesia-EA and NLA). In the test group all patients were operated under EA with local anesthetics combined with intravenous sedative drugs (diprivan + relanium) under conditions of spontaneous respiration and O2 inhalation through a mask. In the control group combined total intravenous anesthesia by myorelaxants and tracheal intubation were carried out (relanium + diprivan: induction dose 1.95 +/- 0.5 mg/kg, maintenance dose 5.3 +/- 0.4 mg/kg/h, and phentanyl). The purpose of the study was to compare the efficiency of anesthesiological protection under EA and traditional NLA in interventions on the spine, when surgical injury is inflicted in the immediate vicinity to the central structures responsible for pain impulsation. Only EA ensured adequate protection of the patients from surgical stress, as was seen from hemodynamic (arterial pressure and heart rate) and endocrine metabolic parameters (glucose, epinephrine, norepinephrine, hydrocortisone, and prolactin levels). Hence, EA fully demonstrated its protective properties during operations on the spine, and therefore can be regarded as a method of choice in this patient population.
Solenkova
A V
AV
Lubnin
A Iu
AIu
Tenedieva
V D
VD
Vorob'ev
Iu V
IuV
Arestov
O G
OG
Shevelev
I N
IN
Konovalov
N A
NA
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods*; D000772:Anesthesia, Local; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D003975:Diazepam / Q000008:administration & dosage; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009458:Neuroleptanalgesia / Q000379:methods*; D015742:Propofol / Q000008:administration & dosage; D012445:Sacrococcygeal Region; D013120:Spinal Cord Neoplasms / Q000601:surgery*
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D003975:Diazepam; D015742:Propofol