Newsletter
Language
Language:
 
News
Archival Issues
Volume 19, 2017
Volume 18, 2016
Volume 17, 2015
Volume 16, 2014
Volume 15, 2013
Volume 14, 2012
Volume 13, 2011
Volume 12, 2010
Volume 11, 2009
Volume 10, 2008
Volume 9, 2007
Volume 8, 2006
Volume 7, 2005
Volume 6, 2004
Volume 5, 2003
Volume 4, 2002
Volume 3, 2001
Volume 2, 2000
Volume 1, 1999
Search
 » 
Journal Abstract
 
Combined subarachnoideal-extradural anesthesia for high-risk patients during surgery on the musculo-skeletal system
Anna Grabowska-Gaweł
Ortop Traumatol Rehabil 2004; 6(3):350-355
ICID: 10671
Article type: Original article
IC™ Value: 5.84
Abstract provided by Publisher
 
Background. Patients in advanced age undergoing surgery for musculo-skeletal disorders are at risk for failure of vital systems under anesthesia. Thus the choice of anesthetic technique for high-risk patients can have a vital impact on treatment outcome.
Material and method. Our research involved 344 patients ranging in age from 69 to 93 (mean 76.4 ± 7.8) at high risk during extensive orthopedic surgery on the lower limbs. The patients were divided into three groups depending on the anesthetic technique used: Group I – general anesthesia with esophageal intubation or laryngeal mask; Group II – subarachnoid anesthesia; and Group III - combined subarachnoid-extradural anesthesia. The Goldman heart risk and ASA anesthesia risk were determined for each patient. The frequency and type of post-operative complications were also specified.
Results. Altogether complications occurred in 15.6% of the patients: 6.1% in Group I, 6.8% in Group II, and 2.9% in Group III. Acute myocardial ischemia and infarct occurred only in patients with high Goldman indices. Pulmonary complications were seen in groups I and II, but not in Group III.
Conclusions. Combined subarachnoid-extradural anesthesia enables deeper anesthesia during a prolonged operation, and thus makes it possible to avoid general anesthesia. The post-surgical application of continuous extradural analgesia using bupivacaine with phentanyl enables the introduction of respiratory rehabilitation and rapid mobilization, reducing the number of cardiac and pulmonary complications, and by the same token shortening the duration of hospitalization.

ICID 10671
PMID 17675997 - click here to show this article in PubMed


Related articles
  • in IndexCopernicus™
         subarachnoid anesthesia [3 related records]
         laryngeal mask [1 related records]
         endotracheal intubation [5 related records]
         orthopedic surgery [4 related records]

  • Related articlesin PubMed database
  • in PubMed database [ related records]


  •  

    Copyright © Ortopedia Traumatologia Rehabilitacja  2017
    Page created by Index Copernicus Ltd. All Rights reserved.