Nazarov G. Monitoring optimization of adequacy of prolonged epidural anesthesia during operations on vessels of the lower extremities

In the work there are provided the results of research on 97 patients with vascular diseases of the lower extremities who were estimated for the adequacy of epidural anesthesia. The initial severity of the disease among the patients was defined, which was determined by the basic pathology and comorbidities, and also risk of injuries in vascular surgery at vascular diseases of the lower extremities. For optimization of adequacy evaluation of epidural anesthesia there is offered the technique of spectral analysis of HRV and APV. It was established, that lidocaine at its use for epidural anesthesia keeps its positions of an effective medicine. There was determined, that data of spectral analysis of HRV and APV during prolonged epidural anesthesia is evident for a sufficient rate of sympathetic blockade, as a component of epidural block. The basic markers of epidural anesthesia adequacy were defined during the monitoring using the method of spectral analysis of HRV and APV e.g. parameters SLFn and SHFn which allow to warn the development of insufficient epidural anesthesia and to individualize prolonged epidural anesthesia. The informativity of the monitoring of epidural anesthesia adequacy by the spectral analysis of HRV and APV using computer complex АРС-2 is confirmed by the research of the adrenaline rate in blood - the standard marker of anesthesia adequacy. The received results allow recommend the technique of prolonged epidural anesthesia using lidocaine with the monitoring of adequacy by the method of spectral analysis of HRV and APV for anesthesia during surgery on the vessels of the lower extremities.