Influence of intra- and postoperative analgesia on hemostatic system of patients with uterine fibromyoma

The aim of the study was to elucidate the effects of the different methods of intra" and postoperative analgesia on functional status of hemostatic system in patients undergoing surgical treatment of uterine fibromyoma. 75 patients aged 35-55 years were examined by the instrumental method of hemocoagulography. The study included four stages: before surgery, one hour after surgery, the first and the third postoperative days. The method of analgesia was selected depending on the type of initial hemostatic dysfunction (hypocoagulation or hypercoagulation). Patients with hypocoagulation underwent general anesthesia while patients with hypercoagulation had epidural anesthesia. Analysis of data revealed that parameters of the hemostatic system after surgery in women with initial hypocoagulation were similar to those in control group. Improvement in parameters of hemostatic system was found in patients with initial hypercoagulation. Both groups of patients underwent multimodal and continuous epidural analgesia in postoperative period. All examined parameters of the hemostasis system remained normal in patients who underwent multimodal analgesia while application of the continuous epidural analgesia resulted in decrease of coagulative potential. Our data suggest that differential approach for selection of the method of intra" and postoperative analgesia in patients undergoing surgical treatment of uterine fibromyoma can be considered a nonspecific preventive measure of thrombotic and hemorrhagic complications.