Importance of epidural anaesthesia and analgesia in prophylaxis of postoperative respiratory dysfunction and complications

Objective: The assessment of postoperative respiratory dysfunction and frequency of complications after abdominal surgery depending on a method of anaesthesia and postoperative analgesia. Methods. 140 patients scheduled to undergo major upper-abdominal surgery have been investigated. Patients were allocated to receive either general anesthesia alone (n=70) or general anesthesia combined with thoracic epidural analgesia (n=70). The course of anaesthesia and the period of postanaesthesia recovery, postoperative pain relief, spirometric parameters, and arterial blood gases were investigated. 2 Results. Use of epidural anaesthesia led to decrease in the charge of anaesthesia medications that was accompanied by faster postanaesthesia recovery. Epidural analgesia provided better quality of pain relief. In all patients decrease in spirometric parameters has been noted. At a system analgesia by narcotic analgetics it has been essentially more expressed, and accompanied by an hypoxemia that demanded oxygenotherapy almost at 1/3 patients. At the prolonged epidural anaesthesia the tendency to depression of frequency of development of a postoperative pneumonia has been noted. Conclusion. The continuous epidural anaesthesia reduces expression of postoperative respiratory dysfunction and creates preconditions to reduction of frequency of complications.