Shaida O. The choice of an anaesthesia/analgesia technique in abdominal surgery in patients with increased cardiac risk

Thesis addresses the prevention of perioperative cardiovascular complications. It was determined that 55% of the patients with increased cardiac risk have preoperative B-type natriuretic peptide (BNP) level higher 250 pg/ml which indicates unsatisfactory cardiac functioning. It was found that independent predictors of intraoperative BNP increase were episodes of tachycardia (heart rate >90 beats/min), bicarbonate concentration (>22,45 mmoll/l), preoperative BNP concentration (<235 pg/ml) and venous blood oxygen capacity (>13,85 mg%). Mean arterial pressure (>107 mmHg), pain scores on coughing (>49,54 mm), preoperative BNP (<230 pg/ml) and fibrinogen (<5,2 g/l) were significantly and independently associated with increase in BNP level in early postoperative period. Thoracic epidural anaesthesia/analgesia was shown to be more effective method of cardioprotection as compared with sevoflurane anesthesia and intraoperative esmolol infusion.