MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA
Is relevant to study the perioperative use of minimal gas flow (minimal flow) during inhalation anesthesia in patients undergoing laparoscopic surgical interventions, in particular with hiatal hernia (HH). The aim of the study. To study the possibility of using minimal flow anesthesia with sevofl...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2022-10-01
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| Series: | Клінічна та профілактична медицина |
| Subjects: | |
| Online Access: | https://cp-medical.com/index.php/journal/article/view/231 |
| _version_ | 1827792087980965888 |
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| author | A. I. Denysenko V. I. Cherniy |
| author_facet | A. I. Denysenko V. I. Cherniy |
| author_sort | A. I. Denysenko |
| collection | DOAJ |
| description | Is relevant to study the perioperative use of minimal gas flow (minimal flow) during inhalation anesthesia in patients undergoing laparoscopic surgical interventions, in particular with hiatal hernia (HH).
The aim of the study. To study the possibility of using minimal flow anesthesia with sevoflurane and evaluate its place in the perioperative management of patients with HH.
Material and methods. The study was prospective, not randomized: 128 patients with HH, who underwent laparoscopic cruroraphy with Nissen fundoplication under general anesthesia with sevoflurane with low and minimal gas flow. Age 33-78 years, ASA II-III. (m.-67, w-61). ). In group I (n=66) Fresh Gas Flow (FGF) = 1,0 l/min, in group II (n=62) – FGF ≤0,5 l/min. All patients underwent personalized perioperative energy monitoring using indirect calorimetry.
The results. The baseline metabolic parameters were without disturbance and significantly exceeded the basal metabolism. Anesthesia in Group I with a gas flow of 1 L/min was more stable, manageable and predictable. In group II with gas flow ≤ 0,5 l/min, at the stage of crurorrhaphy and fundoplication, there was a decrease in the FiO2–FeO2 gradient to 4,4% and a metabolic disorder of 27,2%, which in 14 (22,6%) patients needed a transition for low flow ventilation mode with gas flow 1l/min.
Conclusions. Personalized perioperative energy monitoring makes it safer to perform inhalation anesthesia with gas flow ≤0,5 l/min. in patients with HH. |
| first_indexed | 2024-03-11T17:56:54Z |
| format | Article |
| id | doaj.art-38f69c6780d64a4f9a3c6331fb2a478c |
| institution | Directory Open Access Journal |
| issn | 2616-4868 |
| language | English |
| last_indexed | 2024-03-11T17:56:54Z |
| publishDate | 2022-10-01 |
| publisher | State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department |
| record_format | Article |
| series | Клінічна та профілактична медицина |
| spelling | doaj.art-38f69c6780d64a4f9a3c6331fb2a478c2023-10-17T12:06:34ZengState Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative DepartmentКлінічна та профілактична медицина2616-48682022-10-014485610.31612/2616-4868.4(22).2022.08231MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIAA. I. Denysenko0V. I. Cherniy1State Scientific Institution "Scientific and Practical Center of Preventive and Clinical Medicine" of the State Administration of Affairs, Kyiv, Ukraine State Scientific Institution "Scientific and Practical Center of Preventive and Clinical Medicine" of the State Administration of Affairs, Kyiv, Ukraine Is relevant to study the perioperative use of minimal gas flow (minimal flow) during inhalation anesthesia in patients undergoing laparoscopic surgical interventions, in particular with hiatal hernia (HH). The aim of the study. To study the possibility of using minimal flow anesthesia with sevoflurane and evaluate its place in the perioperative management of patients with HH. Material and methods. The study was prospective, not randomized: 128 patients with HH, who underwent laparoscopic cruroraphy with Nissen fundoplication under general anesthesia with sevoflurane with low and minimal gas flow. Age 33-78 years, ASA II-III. (m.-67, w-61). ). In group I (n=66) Fresh Gas Flow (FGF) = 1,0 l/min, in group II (n=62) – FGF ≤0,5 l/min. All patients underwent personalized perioperative energy monitoring using indirect calorimetry. The results. The baseline metabolic parameters were without disturbance and significantly exceeded the basal metabolism. Anesthesia in Group I with a gas flow of 1 L/min was more stable, manageable and predictable. In group II with gas flow ≤ 0,5 l/min, at the stage of crurorrhaphy and fundoplication, there was a decrease in the FiO2–FeO2 gradient to 4,4% and a metabolic disorder of 27,2%, which in 14 (22,6%) patients needed a transition for low flow ventilation mode with gas flow 1l/min. Conclusions. Personalized perioperative energy monitoring makes it safer to perform inhalation anesthesia with gas flow ≤0,5 l/min. in patients with HH.https://cp-medical.com/index.php/journal/article/view/231hiatal herniaperioperative energy monitoringminimal flow anesthesia |
| spellingShingle | A. I. Denysenko V. I. Cherniy MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA Клінічна та профілактична медицина hiatal hernia perioperative energy monitoring minimal flow anesthesia |
| title | MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA |
| title_full | MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA |
| title_fullStr | MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA |
| title_full_unstemmed | MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA |
| title_short | MINIMAL FLOW ANESTHESIA, ITS PLACE IN PERIOPERATIVE MANAGEMENT IN PATIENTS WITH HIATAL HERNIA |
| title_sort | minimal flow anesthesia its place in perioperative management in patients with hiatal hernia |
| topic | hiatal hernia perioperative energy monitoring minimal flow anesthesia |
| url | https://cp-medical.com/index.php/journal/article/view/231 |
| work_keys_str_mv | AT aidenysenko minimalflowanesthesiaitsplaceinperioperativemanagementinpatientswithhiatalhernia AT vicherniy minimalflowanesthesiaitsplaceinperioperativemanagementinpatientswithhiatalhernia |