Regional anesthesia for removal of chiasmosellar area tumors by endoscopic endonasal transsphenoidal approach
Rationale. Currently is being actively developed a method for removal of chiasmosellar area tumors by endoscopic endonasal transsphenoidal resection, which is considered to be less traumatic and is well tolerated by patients, resulting in an expanded possibility to operate the elder patients, and patients with clinically localized somatic pathology. Objective. Considering the aforesaid, the issue of choosing the adequate anesthetic method and the problem of reducing the perioperative pharmacological load on the patient are brought to the forefront. Materials and Methods. In order to improve the anesthetic management results 200 patients divided into two subgroups have undergone certain examinations. These two subgroups included: a subgroup of 125 patients with general anesthesia and a subgroup of 75 patients with general anesthesia together with the regional one. By use of the undertaken study, we were able to improve successfully the technique of anesthesia for this type of operations through a combination of general and regional anesthesia (bilateral anesthesia of a pterygopalatine fossa). Results and Discussion. A significant decrease in pharmacological load on a patient and stress reaction has been obtained on the background of more stable intraoperative hemodynamics. In addition, a problem of postsurgical pain syndrome control has been considered. For this purpose two subgroups of 20 patients have been allocated: subgroup where patients only received general anesthesia, and the subgroup where the patients received general anesthesia together with regional one, for the purpose of analizing the severity of postsurgical pain on a visual analog pain scale during the day as well as the consumption of analgesics on the patient’s request. For this purpose patients have been divided into two subgroups of 20 people each (subgroup where only general anesthesia was performed, and the subgroup where general anesthesia combined with regional anesthesia was performed), where the severity of postsurgical pain syndrome on a visual analog pain scale during the day has been analyzed, as well as the consumption of analgesics on a patient’s request. Conclusion. As a result, the subgroup of patients received the concomitant anesthesia has shown the best results: there was a significant decrease in pain syndrome intensity on a background of lower consumption of Lornoxicam.
About the authorsKurnosov Alexey B.
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For citation: Kurnosov A.B., Shmigelskiy A.V., Lubnin A.Yu., Kalinin P.L., Kutin M.A., Fomichev D.V., Sharipov O.I. Regional anesthesia for removal of chiasmosellar area tumors by endoscopic endonasal transsphenoidal approach. Regionarnaya аnesteziya i lechenie ostroy boli (Regional Anesthesia and Acute Pain Management) 2017; 11(1): 13–21. (In Russ.). DOI: 10.18821/1993-6508-2017-11-1-13-21
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