Multimodal anesthesia as an integral part of treatment in patients with tibial nonunion in the perioperative period


  • A.K. Rushay Bogomolets National Medical University, Kyiv, Ukraine
  • A.A. Martynchuk Bogomolets National Medical University, Kyiv, Ukraine
  • M.V. Baida Bogomolets National Medical University, Kyiv, Ukraine
  • A.A. Zhagdal Bogomolets National Medical University, Kyiv, Ukraine



tibial nonunion, multimodal analgesia


On the basis of revealed circulatory disorders in the extremity nonunion, the optimal type of preoperative pain management is long-term analgesia in the perioperative period. The quantitative indices of the rheovasography showed a significant decrease in the pulse blood filling of the affected lower extremity, which were caused by an increased tone of the vessels — arteries and veins of medium and small size. The expressed pain syndrome in the preoperative period could aggravate the vascular disorders, which is not a favorable factor in bone fusion. Therefore, the best option is to perform spinal anesthesia in combination with the introduction of dexketoprofen. There were no complications of treatment. Dynamics of indicators on the visual analogue scale testify to the high efficiency of anesthesia performed.


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Original Researches