The study assessed epidural analgesia impact on dynamics of intraabdomenal hypertension in patients with acute large-bowel obstruction during pre-operative period. The large-bowel obstruction results in uniform vascular reaction involved substantial increasing of arterial tone and dramatic reducing of blood flow toward liver and intestine. Early performing of epidural analgesia appeared to adjust pathogenic mechanisms of increasing multiple organ disfunction syndrome along with parallel decreasing of intraabdomenal pressure that suspends tissue hypoxia progression in abdominal aortic area, leveling disorders of splanchnic and systemic hemodynamics.

Both unilateral spinal anaesthesia (USA) and politeal sciatic nerve block (PB) are effective anaesthetic techniques for ankle and foot surgery. In this study hemodynamic data, pain scores and side-effects of USA and PB in elderly patients undergoing transmetatarsal amputation were compared. Thirty ASA II-III randomly assigned patients (70-86 years) received either USA (n=15) or PB (n=15), each under standardized protocols. The results demonstrated that popliteal nerve block provided more stable hemodynamic profile and better postoperative pain control than unilateral spinal anaesthesia. Surgical anaesthesia was achieved in all 30 patients. No complications such as postdural puncture headache, backache, neurological complications or vomiting were noted.

The technique of unilateral epidural anesthesia was presented in this paper as a component of balanced anesthesia and multimodal analgesia for knee arthroplasty. The study includes 12 patients of age from 53 to 71 years old. Unilateral induction of epidural catheter allowed achieving mainly unilateral distribution of local anesthetic in epidural space causing selective sensor and motor block. Unilateral epidural anesthesia provided appropriate protection of the patient from surgical stress and effective postoperative analgesia after knee arthroplasty.