Impact of TAP-block on the Surgical Stress Response after Abdominal Hysterectomy
Purpose of the research was to analyze the various options of postoperative analgesia in terms of their influence on the symptoms of surgical stress response in order to optimize the method of analgesia. Patients (n = 105) were divided into three groups depending on the method of postoperative analgesia. We have monitored the performance of the heart rate variability, the level of daily urine cortisol, as well as changes in the level of blood glucose. The study showed the activation of the regions of the autonomic nervous system in the control group was not significant. In group II, autonomic dysfunction with an increased tone of parasympathetic area has been detected. The use of TAP-block has been characterized by the activation of the regions of the autonomic nervous system. Postoperative hyperglycemia was observed in all groups. The highest rates were in the control group, in group II and III glucose level was lower. Indicators of urine cortisol excretion in the control group were 3 times higher than normal ones. In group II and III — 2.1 and 2.2 times higher, respectively. Increased excretion of daily cortisol indicates the presence of surgical stress in the postoperative period. The use of TAP-block in the postoperative period is characterized by the preservation of adaptive-compensatory reactions in response to surgical intervention, which has an obvious advantage over other methods of postoperative analgesia.
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