title: [New possibilities of complex monitoring of the cardiovascular system during thoraco-abdominal surgeries].
abstract: The aim of the study was to compare effectiveness of combined cardiovascular monitoring in assessment of quality of anesthetic protection during combined general anesthesia with thoracic level epidural analgesia during thoraco-abdominal surgeries. The study included 56 patients (ASA II-IV). The preoperative examination consisted off: ECG (rest), ECG (stress), 24 hour ECG monitoring. The intraoperative hemodynamic parameters (BPsist., BPdiast., BPmed., HR) were monitored both by invasive and non-invasive methods. Using the measurements of cardiac output (extrasternal dopler) the cardiac index, specific peripheral vascular resistance and stroke index were calculated. During intra and postoperative period (1st and 5th day) ECG monitoring was made. The received data was compared according to the following parameters: character of rhythm, circadian index, supraventricular and ventricular ectopic activity, dynamics of the ST segment. The results show that inclusion of thoracic epidural blockade combined with general or total intravenous anesthesia during thoraco-abdominal surgeries is accompanied by more favorable hemodynamic restructuring, heart rate stability and well expressed anti-ischemic effect. Thus, inclusion of modern combined cardiovascular monitoring methods during anesthesia widens the diagnostic abilities and noticeably increases the patient safety during high risk surgeries.
authors.forename: E Iu
authors.initials: EIu
authors.lastname: Upriamova
authors.forename: S P
authors.initials: SP
authors.lastname: Kozlov
authors.forename: V S
authors.initials: VS
authors.lastname: Klimenko
authors.forename: V I
authors.initials: VI
authors.lastname: Stamov
authors.forename: V A
authors.initials: VA
authors.lastname: Svetlov
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000767:Anesthesia, Epidural / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects*; D015716:Electrocardiography, Ambulatory; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019162:Anesthetics, Combined