[Approaches to anesthesia management of a patient during oncological pulmonary surgery].
The results of lungs' excision in 82 patients made under a combined anesthesia of 2 types are comparatively analyzed. A surface low-level endobronchial narcosis by isoflurane was administered in 42 patients concurrently with a "high" epidural anesthesia by bupivakain and fentanyl. The other 40 patients received isoflurane and intravenous bolus injections of fentanyl concurrently with epidural anesthesia by morphine administered at the lumbar level. The epidural analgesia by bupivakain and fentanyl made at the thoracal level or by morphine made at the lumbar level was carried on in the early postoperative period. The results show both variations to ensure a reliable intraoperative anesthesia, a smooth recovery and a good postoperative analgesia. Better results were on the whole obtained by the variant of high epidural anesthesia/analgesia; however, the method of lumbar morphine administration has a number of advantages primarily related with its simplicity.
Gorobets
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ES
Karmanov
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Buĭdenok
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IuV
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000769:Anesthesia, Inhalation; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011184:Postoperative Period; D013510:Pulmonary Surgical Procedures; D013908:Thoracotomy