Comparative assessment of general and regional anesthesia during total endoprosthetic operations on the knee joint
Iudin, A.M.; Fedorov, S.V.; Vedenina, I.V.
Anesteziologiia i Reanimatologiia 2006(4): 43-47
2006
ISSN/ISBN: 0201-7563 PMID: 17061583 Document Number: 600700
The present paper comparatively analyzes anesthetic support in 91 patients during a total endoprosthetic operation on the knee joint. All the patients were conventionally divided into 4 groups: 1) those (n = 7) in whom the operation had been made under general anesthesia (nitrous oxide, ketamine, seduxen, draperidol, and fentanyl); 2) those (n = 36) who had been operated on under epidural anesthesia; 3) those (n = 24) who had intraoperatively received spinal (subarachnoidal) anesthesia; 4) those (n = 24) whom had been intrapperatively given combined spinal and epidural anesthesia.The study established that the above-mentioned general anesthesia failed to produce a steady-state hemodynamics; the earliest postoperative period being accompanied by a significant pain syndrome, which required the use of narcotic analgesics. In Group 2, due to the specific features of the impact of epidural anesthesia itself on different innervation links (A, B, and C), susceptibility to hypotension and the adequacy of this mode of anesthesia were observed, which required the intraoperative additional administration of narcotic agents to enhance anesthesia. Group 3 was marked by a relative postoperative stability of parameters, but a significant pain syndrome is observed in the earliest postoperative period. The best results were obtained in Group 4 patients undergone a combined spinal and epidural anesthesia. The component of subarachnoidal (spinal) anesthesia Marcaine Spinal provided a sufficient intraoperative analgesic effect and the component of epidural anesthesia induced virtually no pain syndrome under continuous epidural block.