Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients
Objective: to optimize anesthetic tactics for perioperative management in elderly patients during lower abdominal surgery under mixed anesthesia with preserved spontaneous breathing without myoplegia. Subjects and methods. Examinations were made in 142 patients aged over 65 years. The patients were...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2011-12-01
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| Series: | Общая реаниматология |
| Online Access: | https://www.reanimatology.com/rmt/article/view/255 |
| _version_ | 1797874281940516864 |
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| author | V. V. Likhvantsev D. D. Selivanov S. A., Fedorov O. A. Grebenchikov A. S. Murachev S. S. Timoshin |
| author_facet | V. V. Likhvantsev D. D. Selivanov S. A., Fedorov O. A. Grebenchikov A. S. Murachev S. S. Timoshin |
| author_sort | V. V. Likhvantsev |
| collection | DOAJ |
| description | Objective: to optimize anesthetic tactics for perioperative management in elderly patients during lower abdominal surgery under mixed anesthesia with preserved spontaneous breathing without myoplegia. Subjects and methods. Examinations were made in 142 patients aged over 65 years. The patients were divided into 2 groups: 1) inhalation anesthesia under total myoplegia and controlled mechanical ventilation (MV); 2) inhalation anesthesia without myoplegia with preserved spontaneous breathing or assisted mechanical ventilation (AMV) in the pressure-support (PS) mode. Results and discussion. The AMV procedure allows mixed anesthesia with preserved spontaneous breathing in elderly patients during operations on the lower abdomen and great vessels in 89% of the patients without a risk for inadequate transport of oxygen under its relative uptake. MV used to maintain external respiratory function under mixed anesthesia and total myoplegia causes a decrease in cardiac index (CI) by 58.8% (p<0.05) and increases in total peripheral resistance (TPR) by 50% or more (p<0.05), and intrapulmonary shunt threefold (p<0.05). Mixed anesthesia without myoplegia and MV prevents induced changes in CI, TPR, and Qs/Qt. The differences were significant throughout the follow-up (an intraoperative stage and 9 postoperative hours). The older age group patients are more susceptible to the damaging action of MV; they were also found to have a more pronounced preventive effect of modified anesthesia. Conclusion. To rule out myoplegia and MV during mixed anesthesia prevents MV-induced changes in CI, TPR, and Qs/Qt. Key words: mixed anesthesia in elderly patients, spontaneous breathing, hemodynamics, blood oxygen transporting function. |
| first_indexed | 2024-04-10T01:29:30Z |
| format | Article |
| id | doaj.art-8d4bf61c4e27418587eb6e087dc9d5c1 |
| institution | Directory Open Access Journal |
| issn | 1813-9779 2411-7110 |
| language | English |
| last_indexed | 2024-04-10T01:29:30Z |
| publishDate | 2011-12-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj.art-8d4bf61c4e27418587eb6e087dc9d5c12023-03-13T09:32:51ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102011-12-017610.15360/1813-9779-2011-6-46255Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly PatientsV. V. LikhvantsevD. D. SelivanovS. A., FedorovO. A. GrebenchikovA. S. MurachevS. S. TimoshinObjective: to optimize anesthetic tactics for perioperative management in elderly patients during lower abdominal surgery under mixed anesthesia with preserved spontaneous breathing without myoplegia. Subjects and methods. Examinations were made in 142 patients aged over 65 years. The patients were divided into 2 groups: 1) inhalation anesthesia under total myoplegia and controlled mechanical ventilation (MV); 2) inhalation anesthesia without myoplegia with preserved spontaneous breathing or assisted mechanical ventilation (AMV) in the pressure-support (PS) mode. Results and discussion. The AMV procedure allows mixed anesthesia with preserved spontaneous breathing in elderly patients during operations on the lower abdomen and great vessels in 89% of the patients without a risk for inadequate transport of oxygen under its relative uptake. MV used to maintain external respiratory function under mixed anesthesia and total myoplegia causes a decrease in cardiac index (CI) by 58.8% (p<0.05) and increases in total peripheral resistance (TPR) by 50% or more (p<0.05), and intrapulmonary shunt threefold (p<0.05). Mixed anesthesia without myoplegia and MV prevents induced changes in CI, TPR, and Qs/Qt. The differences were significant throughout the follow-up (an intraoperative stage and 9 postoperative hours). The older age group patients are more susceptible to the damaging action of MV; they were also found to have a more pronounced preventive effect of modified anesthesia. Conclusion. To rule out myoplegia and MV during mixed anesthesia prevents MV-induced changes in CI, TPR, and Qs/Qt. Key words: mixed anesthesia in elderly patients, spontaneous breathing, hemodynamics, blood oxygen transporting function.https://www.reanimatology.com/rmt/article/view/255 |
| spellingShingle | V. V. Likhvantsev D. D. Selivanov S. A., Fedorov O. A. Grebenchikov A. S. Murachev S. S. Timoshin Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients Общая реаниматология |
| title | Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients |
| title_full | Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients |
| title_fullStr | Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients |
| title_full_unstemmed | Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients |
| title_short | Specific Features of Mixed Anesthesia with Preserved Spontaneous Breathing in Elderly Patients |
| title_sort | specific features of mixed anesthesia with preserved spontaneous breathing in elderly patients |
| url | https://www.reanimatology.com/rmt/article/view/255 |
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