The choice of anesthetic management for cholecystectomy in elderly patients

The article presents study data that allowed the authors to develop an algorithm of choice of perioperative management and method of anesthesia in the surgical treatment of cholelithiasis in persons older than 60 years based on analysis of the state of the autonomic nervous system (ANS). Modern indicators of heart rate variability were studied: NN, SpO2, SDNN, НRV, RMSSD, HRV index, AMo, Moda, SIM, PAR. Using mathematical methods of analysis, we obtained mathematical models and trends, allowing to identify initially abnormal state of the ANS in elderly patients, peculiarities of response of heart rate variability to surgical aggression under sevoflurane-based general anesthesia and total intravenous anesthesia, and to choose the best surgical and anesthetic approach. The smallest changes in this group of patients were observed during laparoscopic cholecystectomy under general anesthesia with sevoflurane.