COURSE OF INHALATION ANAESTHESIA WITH SEVOFLURANE DURING SURGICAL TREATMENT OF PATIENTS WITH MALIGNANT LUNG TUMOURS

Abstract

Abstract. Aim. Study of the effect of pain intensity on the energy efficiency of blood circulation in patients with lung malignancies after operations under anesthesia using sevoflurane. Materials and methods. 29 patients with malignant lung formations have been examined, who underwent open surgical interventions on the volume of lob- or pneumonectomy or resection of part of the lung. The average age of the examined patients was (55±5.6) years, among them men – 17, women – 12. Pain intensity, perfusion systemic pressure, cardiac index, blood flow power, arteriovenous difference in oxygen content, blood lactate concentration, oxygen reserve, circulatory reserve have been determined. These indicators have been determined in four stages: 1) before the operation; 2) awakening; 3) the first day after surgery; 4) the fifth day after surgery. Results and their discussion. The intensity of pain determined by the visual analog scale (VAS) was maximum on the 1st day after surgery (4.8±0.8 points), and on the 5th day it returned to the level of the awakening stage. Analgesia was performed with morphine (0.27±0.04 mg/kg on the 1st day) and infusion of infulgan at a dose of 1 g 3 times a day. The circulatory reserve was minimal at the stage of awakening and on the 1st day after surgery (from (381±66) to (390±71) mW/m2), on the 5th day it reached the preoperative level (448±82 mW/m2). Separate indicators of blood circulation do not have a strong dependence on the level of pain that was determined by VAS, but indicators of the energy component of circulation are closely related to the severity of pain. Conclusions. The maximum severity of pain in patients with malignant lung formations operated under inhaled anesthesia with sevoflurane is observed on the first day after surgery. Different indicators of hemodynamics and oxygen transport are associated with the intensity of pain measured by VAS with different strengths, which makes it impossible to evaluate the effectiveness of anesthesia. Indicators of circulatory energy efficiency are closely related to the intensity of pain measured using VAS, which proves the value of using monitoring of circulatory energy indicators in assessing the quality of anesthesia.