Effects of regional anaesthesia and analgesia on changes in hemostasis in abdominal surgery

The aim of the study - evaluation of hemostasis/fibrinolysis changes in abdominal surgery, depending on the option of anesthesia and postoperative analgesia. Methods. 120 Patients scheduled to undergo elective abdominal surgery were allocated to receive either general anesthesia alone (n=40) or general anesthesia combined with epidural (n=40) or spinal (n=40) anesthesia. Postoperative pain relief, glucose and cortisol levels, coagulation, fibrinolysis and platelets aggregation parameters were investigated. Results. It was found that both epidural and spinal anaesthesia limited increase of glucose and cortisol concentration after surgery. In the postoperative period activation of coagulation and platelet aggregation with acceleration of fibrinolysis (only after general anaesthesia) were noted. These changes were significantly less expressed at use of both kinds of regional anesthesia. It was observed a higher quality of postoperative pain relief in the epidural group. There was no significant difference in the frequency of complications. Conclusion. Both spinal and epidural analgesia limit changes in hemostasis/fibrinolysis in abdominal surgery.