Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators)
The objective: to analyze the contemporary specific parameters of intraoperative management of epidural analgesia (EA) in combined anesthesia in abdominal oncological surgeries in different medical organizations of Russia.Subjects and Methods. The data necessary for analysis and statistical processi...
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New Terra Publishing House
2022-08-01
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| Series: | Вестник анестезиологии и реаниматологии |
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| Online Access: | https://www.vair-journal.com/jour/article/view/696 |
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| author | N. S. Smolin K. N. Khrapov V. M. Miroshkina |
| author_facet | N. S. Smolin K. N. Khrapov V. M. Miroshkina |
| author_sort | N. S. Smolin |
| collection | DOAJ |
| description | The objective: to analyze the contemporary specific parameters of intraoperative management of epidural analgesia (EA) in combined anesthesia in abdominal oncological surgeries in different medical organizations of Russia.Subjects and Methods. The data necessary for analysis and statistical processing were obtained by developing a formalized questionnaire (21 questions, some of which with the possibility of choosing several answers at the same time – multiple choice), published on the official website of the Association of Anesthesiologists-Resuscitators (https://association-ar.ru/). The survey lasted for 16 days (from May 23, 2022 to June 7, 2022). The survey results were collected using the Google Forms online service and processed using the Google Spreadsheets. Multiple choice responses were processed as absolute numbers and presented as a percentage of the total number of responses to a particular question.Results. The total number of respondents who took part in the survey was 217 specialists from various medical organizations, mostly from the North-Western Federal District of the Russian Federation (34.1%) with more than 15 years of expertise in the specialty (44.7%). According to the survey results, the following specific features of EA during combined anesthesia practice in Russia have been identified: most participants perform EA in the sitting position (63.6%); ropivacaine is the drug of choice among local anesthetics (LA) (84.2%); as a rule, EA is initiated prior to incision (69.6%). During open surgical interventions, 44.7% use a combined EA method (continuous infusion and bolus injection – bolus-based mode), while during laparoscopic surgeries there is no preferred method (combined method – 33.1%; continuous infusion only – 35.5%; bolus injection only – 31.4%). Low concentrations of LA (0.2 ‒ 0.375%) combined with a low volume of administration (4‒10 ml for bolus, 4‒8 ml/h for infusion) are used more often both in open and laparoscopic surgeries. In most cases, achievement of effective EA is supported by lower doses of systemic opioid analgesics (65.4%). Insufficient degree of intraoperative analgesia is managed in different ways, such as using systemic opioids (68.7%), enhancing epidural analgesia (17.5%), and administration of non-opioid analgesics (13.8%).Conclusion. At present, there is no unified approach to the method of EA in combined anesthesia. The results of the survey showed the uncertainty of experts' opinions regarding the choice of LA concentrations for EA, the rate and volume of its administration into the epidural space. Finding the optimal method of intraoperative EA in abdominal oncological surgery is the most important clinical objective in terms of reducing perioperative complications. |
| format | Article |
| id | doaj-art-2678a7c3dc7f4df990f983bc0e55c293 |
| institution | DOAJ |
| issn | 2078-5658 2541-8653 |
| language | Russian |
| publishDate | 2022-08-01 |
| publisher | New Terra Publishing House |
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| series | Вестник анестезиологии и реаниматологии |
| spelling | doaj-art-2678a7c3dc7f4df990f983bc0e55c2932025-08-20T03:18:55ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532022-08-01194616810.21292/2078-5658-2022-19-4-61-68538Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators)N. S. Smolin0K. N. Khrapov1V. M. Miroshkina2Pavlov First Saint Petersburg State Medical UniversityPavlov First Saint Petersburg State Medical UniversityPavlov First Saint Petersburg State Medical UniversityThe objective: to analyze the contemporary specific parameters of intraoperative management of epidural analgesia (EA) in combined anesthesia in abdominal oncological surgeries in different medical organizations of Russia.Subjects and Methods. The data necessary for analysis and statistical processing were obtained by developing a formalized questionnaire (21 questions, some of which with the possibility of choosing several answers at the same time – multiple choice), published on the official website of the Association of Anesthesiologists-Resuscitators (https://association-ar.ru/). The survey lasted for 16 days (from May 23, 2022 to June 7, 2022). The survey results were collected using the Google Forms online service and processed using the Google Spreadsheets. Multiple choice responses were processed as absolute numbers and presented as a percentage of the total number of responses to a particular question.Results. The total number of respondents who took part in the survey was 217 specialists from various medical organizations, mostly from the North-Western Federal District of the Russian Federation (34.1%) with more than 15 years of expertise in the specialty (44.7%). According to the survey results, the following specific features of EA during combined anesthesia practice in Russia have been identified: most participants perform EA in the sitting position (63.6%); ropivacaine is the drug of choice among local anesthetics (LA) (84.2%); as a rule, EA is initiated prior to incision (69.6%). During open surgical interventions, 44.7% use a combined EA method (continuous infusion and bolus injection – bolus-based mode), while during laparoscopic surgeries there is no preferred method (combined method – 33.1%; continuous infusion only – 35.5%; bolus injection only – 31.4%). Low concentrations of LA (0.2 ‒ 0.375%) combined with a low volume of administration (4‒10 ml for bolus, 4‒8 ml/h for infusion) are used more often both in open and laparoscopic surgeries. In most cases, achievement of effective EA is supported by lower doses of systemic opioid analgesics (65.4%). Insufficient degree of intraoperative analgesia is managed in different ways, such as using systemic opioids (68.7%), enhancing epidural analgesia (17.5%), and administration of non-opioid analgesics (13.8%).Conclusion. At present, there is no unified approach to the method of EA in combined anesthesia. The results of the survey showed the uncertainty of experts' opinions regarding the choice of LA concentrations for EA, the rate and volume of its administration into the epidural space. Finding the optimal method of intraoperative EA in abdominal oncological surgery is the most important clinical objective in terms of reducing perioperative complications.https://www.vair-journal.com/jour/article/view/696surveyepidural analgesiacombined anesthesiamethod of epidural analgesiaintraoperative epidural analgesia |
| spellingShingle | N. S. Smolin K. N. Khrapov V. M. Miroshkina Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators) Вестник анестезиологии и реаниматологии survey epidural analgesia combined anesthesia method of epidural analgesia intraoperative epidural analgesia |
| title | Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators) |
| title_full | Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators) |
| title_fullStr | Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators) |
| title_full_unstemmed | Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators) |
| title_short | Epidural Analgesia as a Part of Combined Anesthesia during Abdominal Oncological Surgeries (Results of the Survey among the Russian Anesthesiologists and Resuscitators) |
| title_sort | epidural analgesia as a part of combined anesthesia during abdominal oncological surgeries results of the survey among the russian anesthesiologists and resuscitators |
| topic | survey epidural analgesia combined anesthesia method of epidural analgesia intraoperative epidural analgesia |
| url | https://www.vair-journal.com/jour/article/view/696 |
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