RATIONALE FOR SPINAL-EPIDURAL ANESTHESIA DURING EXTENDED RECONSTRUCTIVE-PLASTIC OPERATIONS IN UROLOGY

Abstract

The authors conducted a comparative assessment of the clinical efficacy of spinal-epidural and epidural components combined with general anesthesia based on sevoflurane in patients with radical cystectomy and simultaneous ileocystoplasty.Study design - prospective, controlled, non-randomized, single-center. Control group (n-58) underwent epidural anesthesia with endotracheal anesthesia on the basis of sevoflurane. The main group (n-58) had a combination of neuroaxial blockade with endotra-cheal anesthesia on the basis of sevoflurane.Dynamics of intra-operative hemodynamics and oxygen transport in patients of two groups were similar in nature; no inter- group differences were found. During the most traumatic time of surgery, cortisol and glucose levels were significantly higher in pa- tients in the control group. We revealed the insolvency of the microcirculation in the area of operational fields in patients without spinal-epidural anesthesia.Thus, during extended, radical, reconstructive-plastic surgical interventions in patients with advanced bladder cancer combined spinal-epidural anesthesia with endotracheal anesthesia on the basis of sevoflurane is more safe.