Zaichenko P. Hemodymanic Disorders and Ways of Their Correction During Anesthesiologicaly Provision Reconstruction Operation of Aorta and Artery in Lower Limbs

This paper deals with the results of research of 266 patients with obliterating atherosclerosis of aorta and great vessels of lower limbs, who show mainly hypodynamic type of blood circulation that appears as diminution of stroke volume and cardiac output. There has been studied the effect of first line preparations used for treatment of ischemic heart disease and hypertonic disease on decrease of a number of postoperative complications. The findings show that the agents of choice are angiotensin-converting enzyme inhibitors that reduce blood pressure and assist to increase of stroke volume, cardiac output and regional blood flow index; calcium antagonists that increase cardiac output and decrease regional hemodynamic index; blockers of ?-adrenoreceptors that significantly reduce rate of cardiac beat, cardiac output and regional blood circulation. Studies of the effect of epidural anesthesia on hemodynamic index showed increase of stroke volume and blood flow volume in ischemic limbs and decrease of anumber of postoperative complications by 1,9 times as compared to general anesthesia. The obtained data allow to recommend using epidural anesthesia for reconstructive surgery of aorta and blood vessels in lower limbs, and correction of pathogenetic changes in patients with accompanying hypertonic and ischemic heart disease.