THE PECULIARITIES OF THE POSTANESTHETIC PERIOD IN PATIENTS WITH EXTENSIVE ABDOMINAL OPERATIONS
Compensatory and adaptive mechanisms in the postanesthetic period in some cases turn out to be inadequate to such an extent that lead to the development of complications of various systems of the body. The criteria of adequacy and recovery from anesthesia are stable indices of vital physiological functions, the restoration of protective reflexes, muscle tone and the ability to exercise commands. The aim of the research was to identify key indicators of the restoration of the cardiovascular, respiratory, central nervous system functions in patients with extensive abdominal operations in the postanesthetic period. 178 patients with extensive abdominal operations were examined. All patients were divided into 3 groups. The first group included 76 patients who received combined anaesthesia (fentanyl, izoflûran, pipecuronium bromide); the second group consisted of 50 patients with intravenous anesthesia with ketamine; the third group comprised 52 patients with intravenous anesthesia with propofol. All surgical interventions were performed under conditions of artificial lung ventilation. In the postanesthetic period hemodynamics, respiratory support, acid-base equilibrium indices were studied, the state of the consciousness and muscle tone was evaluated.It has been found that in patients having undergone the operation under the combined anesthesia and the intravenous one with propofol the fastest postanesthetic functions restoration is observed. In case of the combined anesthesia andthe intravenous one with propofol the remaining myoplegia is the limiting factor of the restoration and after intravenous anesthesia by means of ketamine - slow awakening.