Effect of epidural anesthesia on hemodynamics and gemostasis sistem in operations of correction of scoliosis

The purpose of the study is assessment of effects of epidural anesthesia on systemic haemodynamics, the hydration state of the lungs and the haemostatic system during surgical corrections of scoliosis. The study included 110 patients. Two-level thoracic epidural anesthesia with 0.75% ropivacaine and general anesthesia with sevoflurane were used in the first group and only general anesthesia with sevoflurane and fentanil was used in the second group during the surgery Patients in both groups received a bolus of 15 mg/kg tranexamic acid (TA), followed by infusion of 0.04 mg/kg/min to sewing up the wound. The main effect of reducing intraoperative blood loss by 60% (524 ml, p=0.0013) was obtained in the first group. Noninvasive hemodynamic monitoring showed that EA does not lead to life- threatening disorders in myocardial contractility, cardiac output, systemic vascular resistance and critical increase of the content of extravascular lung water. Effect of EA on hemostasis is to limit the activation both coagulation and fibrinolysis.