Choice of the method of anesthesia management of traumatological surgeries in young patients
DOI:
https://doi.org/10.15587/2313-8416.2015.47374Keywords:
hemodynamics, conduction anesthesia, general anesthesia, trauma of limbs, stress markers, pain levelAbstract
Aim of research. Study of the hemodynamic state, evaluation of the pain level, stress markers and its correlations in traumatologic patients of the young age in conditions of the different kinds of anesthesia.
Materials and methods. The research includes 102 patients: 72 men (70,6 %), 30 women (29,4 %) 18 – 45years old (33,5±0,7 years), who underwent osteosynthesis because of traumatic injure of limbs. Patients were separated into 3 groups depending on the kind of anesthesia: I group (n=32) – underwent surgery in conditions of conduction anesthesia without sedation (average age 31,9±1,3 years), II group (n=44) – underwent surgery in conditions of conduction anesthesia with sedation (35,0±1,0 years), III group (n=26) – underwent surgery in conditions of intravenous anesthesia (32,7±1,4years).
Results of research. MAPB level at the surgery stages didn’t exceed the output values in patients of all groups. As for HR it must be noticed its increase in patients of the 1 and II groups at the traumatic stage and at the end of surgery that can be explained by an effect of adrenaline added to the local anesthetic. The pain level was the lowest in the group of patients who underwent an anesthesia with sedation in first postsurgical day. Hyperglycemia was noticed in patients of the 1 group in first postsurgical day, and in patients of the III group – the tendency to hypercortisolemia. The cortisone-insulin ratio at the surgery stages was maximal in patients of the 1 group and in postsurgical day – in the III group. НОМА index at the surgery stages was within norm in patients of all groups and only in postsurgical day it had a tendency to increase in patients of the I group.
Conclusions. Conduction anesthesia without sedation, conduction anesthesia with sedation (propofol) and intravenous anesthesia (propofol, fentanyl) demonstrate hemodynamic stability at osteosynthesis in young patients. The conduction anesthesia with sedation (propofol) and intravenous anesthesia (propofol, fentanyl) have a high level of anti-stress activity at osteosynthesis in young patients.
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