Abstract
Currently, anesthesiologists-resuscitators have a large number of sedatives (hypnotics, general anesthetics, anxiolytics), but many of them, in addition to the main action, give a number of side effects or do not provide optimal sedation. On the other hand, there are new modern drugs for sedation, thus, the need to correct existing regimens of sedative therapy is quite timely and necessary.
The aim of the study was to examine the advantages and disadvantages of different sedation methods in patients with urological profile operated under spinal anesthesia.
80 patients (54 men and 26 women) who underwent urological surgery under balanced anesthesia (spinal anesthesia in combination with drug sedation) were examined. Patients were randomly divided into two groups. Group 1 (n = 40) – sedation with dexdor, group 2 (n = 40) – sedation with diprivan. The level of sedation was assessed using the RAMSEY scale, the degree of post-anesthesia recovery on the Bidway five-point scale, and anesthesia satisfaction was assessed using the Lowa Satisfaction with Anesthesia Scale (ISAS). The degree of hemodynamic disorders was determined by continuous monitoring of heart rate, blood pressure and ECG. The normality of the distribution was checked using the Shapiro–Wilk method. The Mann–Whitney test was used to assess the statistical significance of the difference between the two independent groups.
Results. The study showed that a deeper level of sedation during surgery was observed in the second group (sedation with diprivan). In this group, postoperative drowsiness was also higher both during the first 15 minutes and 30 minutes after surgery. Despite the fact that patients receiving dexdor had more superficial sedation, they generally showed significantly higher overall satisfaction with anesthesia. The study proved the effectiveness and safety of both drugs for sedation in urological patients under spinal anesthesia. However, a number of important advantages of dexdor were found as compared to diprivan. Dexdor, due to its ability to cause mild to moderate sedation, allows the patient to contact staff, almost does not suppress respiration, lets the patient feel comfortable and causes sufficient retrograde amnesia.