EVALUATION OF SYMPATHETIC BLOCKADE UNDER THORACIC EPIDURAL VERSUS BILATERAL PARAVERTEBRAL ANESTHESIAS DURING HIGH-TRAUMATICITY OPERATIONS ON THE UPPER ABDOMINAL ORGANS

• Main Authors: A. M. Dzyadzko, L. S. Bolonkin, A. F. Minov, A. B. Piskun, O. A. Chugunova, M. L. Katin, A. A. Brukhatsky, A. M. Fedoruk, A. E. Shcherba
• Format: Article
• Language: Russian
• Published: NEW TERRA Publishing House 2017-11-01
• Series: Вестник анестезиологии и реаниматологии
• Subjects: paravertebral anesthesia; epidural anesthesia; sympathetic blockade; arterial resistance index
• Online Access: https://www.vair-journal.com/jour/article/view/7

Objective: to compare the degree of sympathetic blockade caused by thoracic epidural or bilateral paravertebral anesthesia. Superior mesenteric artery blood flow was measured calculating the coefficient of flow resistance (resistance index) as an indicator of the degree of sympathetic block in patients undergoing high-traumaticity operations on the upper abdominal organs under thoracic epidural or bilateral paravertebral anesthesia. The patients of both groups were noted to develop sympathetic blockade with a statistically significant reduction in vascular resistance (resistance index) of the superior mesenteric artery and with an increase in blood flow in the visceral bed. The degree of sympathetic blockade was statistically significantly higher in patients under epidural anesthesia. Conclusion. Bilateral thoracic paravertebral blockade decreases sympathetic nervous system activation and may be used during high-traumaticity surgery if there are existing or predictable contraindications to epidural anesthesia.