Vybor metoda neyroaksial'noy blokady pri operatsiyakh total'nogo endoprotezirovaniya tazobedrennogo sustava u bol'nykh pozhilogo vozrasta

Abstract

Total hip endoprosthesis (THEP) is the reference orthopedic operation that demonstrates, to the greatest extent, the impact of the choice of an optimum method for anesthesia and perioperative intensive care on the outcome of surgical treatment and the frequency of complications, including fatal outcomes. The efficiency of 3 types of neuroaxial block was evaluated in 108 patients during THEP operations. Thirty-two patients constituting Group 1 were operated on under epidural block; in Groups 2 (n = 37) and 3 (n = 39), surgical interventions were made under spinal block and unilateral spinal anesthesia (USA), respectively. All these three types of neuroaxial blocks were shown to ensure the sufficient extent of sensory block and the depth of motor block as well as their duration, which created optimal conditions for THEP. When their methodology is followed, neuroaxial blocks are quite safe anesthetic modes. At the same time, USA is, in terms of a risk for arterial hypertension, safer for elderly patients during THEP. When USA is applied, there is less need for infused sympathomimetics to maintain blood pressure during THEP.