The choice of the method of anesthetic management of gynecological operations in patients with different sensitivity of peripheral chemoreflex

Abstract

Objective — comparative assessment of spinal and epidural anesthesia during gynecological operations in patients with different sensitivity of peripheral chemoreflex.

Material and Methods. Prospective observational blind study, 152 gynecological patients, elective surgery. The day before the surgery, the sensitivity of peripheral chemoreflex was determined by the duration of an arbitrary threshold apnea in a test with a delayed respiration. According to the duration of the test, the patients were divided into groups: high risk of developing complications (group “1”) and low risk of developing complications (group “2”). Each group contains subgroups depending on the type of anesthesia: spinal or epidural. During the operation and in the early postoperative period, critical incidents were recorded.

Results and Conclusion(s). During anesthesia in gynecological patients from intraoperative critical incidents is revealed hypotension. The use of epidural anesthesia in patients with a high risk of developing complications can reduce the incidence of hypotension and postoperative complications. In patients with a low risk of developing complications, both epidural and spinal anesthesia can be used.

Keywords

spinal anesthesia / epidural anesthesia / critical incidents / peripheral сhemoreflex sensitivity / gynecological surgery

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