cArdioprotective effect of thorAcic epidurAl AnesthesiA during operAtions on the infrArenAl AortA
Two hundred and thirty-seven patients aged 54 to 69 years who had undergone aortobifemoral bypass surgery for atherosclerosis of the aorta and its branches were examined. According to the anesthesia mode, the patients were divided into 3 groups: 1) patients were operated on under neuroleptic analgesia; 2) those who received general anesthesia in combination with epidural block at the level of Th12-L1; 3) those who had thoracic epidural block at the level of Th10-Th11 along with general anesthesia. Anesthesia provided for artificial ventilation in all cases. The patient groups were representative. The highest and steady-state values of coronary blood flow and central hemodynamics proved to be in Group 3 patients. Myocardial sympathetic innervation block ensured the highest and steady-state values of coronary blood flow, stroke index, and ejection fraction as compared with those in the patients from the other groups. Introduction of the procedure of continuous thoracic epidural anesthesia (Th10-Th11) caused a reduction in the number of postoperative complications (hyper- and hypotension, myocardial ischemia, rhythm disturbances).