Optimization of Anesthetic Management of Peri- and Postoperative Period in Surgical Treatment of Colorectal Cancer

K.O. Chebanov, I.V. Baranov, S.P. Novikov, Yu.I. Olefir, S.A. Hryshko, O.V. Vasylishin, R.K. Karas

Abstract


The purpose of the research — to select the optimal method of anesthesia to protect patients from operating aggression in the surgical treatment for colorectal cancer. We have performed a comparative analysis of clinical data and treatment outcomes when using ataralgesia, followed by analgesia with narcotic analgesics, and combined technique using low-flow sevoflurane anesthesia and epidural analgesia, with subsequent continuous epidural anesthesia. It was shown a significant advantage of the combined method over the total intravenous anesthesia due to: normodynamic type of hemodynamics during the entire surgery, early regression of postanesthesia depression and possible patient’s extubation in the operating room, the effective analgesia in the early postoperative period. Technique of continuous epidural analgesia in comparison with opiate analgesia provided a significant reduction in the need for opioid analgesics, efficient and high-quality analgesia in the postoperative period, leveled the side effects of opioid drugs, reduced the length of stay of the patient in the intensive care unit. The implemented methodology has reduced the incidence of postoperative mortality, the number of complications, average length of hospital stay and rate of patients’ readmission to the intensive care unit.


Keywords


colorectal cancer; low-flow anesthesia; combined anesthesia; continuous epidural analgesia; sevoflurane

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DOI: https://doi.org/10.22141/2224-0586.4.75.2016.75833

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