title: [Preoperative preparation of patients with critical lower limb ischemia and pronounced painful syndrome].
abstract: Presented herein are the data on the condition of central and cerebral hemodynamics in 98 patients with chronic stage III-IV lower limb ischemia and coexistent CAD as dependent, on the severity of painful syndrome as well as on the necessity of preparing patients at a high surgical risk for reconstructions under prolonged epidural anesthesia. The prognostically dangerous changes in central and cerebral hemodynamics were revealed in persons with severe painful syndrome. In 87% of patients, circulation was hypokinetic. Twenty-six patients with unremovable pain and severe coexistent diseases underwent, as preoperative preparation, prolonged epidural anesthesia. It has been proven that prolonged epidural anesthesia allows to reach not only a good analgetic effect but also to refine the indicators of central and cerebral hemodynamics whereby preventing intra- and postoperative ischemic events.
authors.forename: Iu I
authors.initials: IuI
authors.lastname: Kazakov
authors.forename: I V
authors.initials: IV
authors.lastname: Belov
authors.forename: M G
authors.initials: MG
authors.lastname: Khatyov
authors.forename: S I
authors.initials: SI
authors.lastname: Sitkin
mesh_terms: D015360:Analgesia, Epidural; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D011300:Preoperative Care; D013562:Sympathectomy; D013997:Time Factors