PREOPERATIVE PREPARATION OF PATIENTS WITH CRITICAL LOWER LIMB ISCHEMIA AND PRONOUNCED PAINFUL SYNDROME

Yu.I. Kazakov, I.V. Belov, M.G. Khatypov, S.I. Sitkin
Chair of Cardiovascular Surgery, Anesthesiology and Resuscitation,
Tver State Medical Academy,
Tver, Russia

Presented herein are the data on the condition of central and cerebral hemodynamics in 98 patients with chronic stage III–IV lower limb ischemia and coexistent CAD as dependent, on the severity of painful syndrome as well as on the necessity of preparing patients at a high surgical risk for reconstructions under prolonged epidural anesthesia. The prognostically dangerous changes in central and cerebral hemodynamics were revealed in persons with severe painful syndrome. In 87% of patients, circulation was hypokinetic.

Twenty-six patients with unremovable pain and severe coexistent diseases underwent, as preoperative preparation, prolonged epidural anesthesia. It has been proven that prolonged epidural anesthesia allows to reach not only a good analgetic effect but also to refine the indicators of central and cerebral hemodynamics whereby preventing intra- and postoperative ischemic events.

KEY WORDS: critical lower limb ischemia, painful syndrome, epidural anesthesia.

P. 77

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