Effect of prolonged epidural analgesia on ventilation and perfusion of the lungs in early postoperative period in lung cancer patients

Abnormalities in pulmonary ventilation and perfusion are observed in postoperative period in lung cancer patients due to breathing biomechanics damages caused by pain syndrome. It often results in complications in the form of pulmonary atelectasis and pneumonies. In our study, lung cancer patients underwent infusion thoracic epidural analgesia for postoperative pain control after radical operation on the lungs. To assess the effect of infusion thoracic epidural analgesia on pulmonary ventilation and perfusion processes, ventilation-perfusion scintigraphy was performed. The study results showed, that in early postoperative period, parameters of ventilation-perfusion ratio (V/Q) and apex-base gradient of perfusion (U/L-Q) and ventilation (U/L-V) were in normal limits in lung cancer patients who underwent prolonged thoracic epidural analgesia, whereas perfusion abnormalities took place in the control group patients who did not undergo prolonged thoracic epidural analgesia. Thus, prolonged thoracic epidural analgesia is the effective method for prevention of pulmonary perfusion and ventilation abnormalities in early postoperative period at surgical stage of combined treatment for lung cancer.