Kabakov B. Optimizing perioperative analgesia in patients with lower extremity occlusive disease

The thesis devoted to optimize anesthesia tactics in reconstructive interventions on major vessels of the lower extremities. Work have been performed in the Central Clinical Hospital of Ukrainian Railroad. In accordance with the intended purpose, 94 patients with lower extremity occlusive disease were enrolled. Patients were randomized into two comparison groups: I (n = 64) - control, where epidural anesthesia and ketorolac have used. II (n = 30) - the study group, in which an original technique of prolonged perineural femoral nerve blockade was additionally used. The use of prolonged perineural femoral nerve blockade in surgical correction of atherosclerotic vascular lesions of the lower extremities is the peculiarity of proposed method, due to which it was possible to adapt hemodynamics, oxygen metabolism, and patient satisfaction with anesthesia. Detected differences have allowed to optimize an anesthetic approach during reconstructive surgery on the great vessels of the lower extremities according to improvement of the flow reperfusion period. The technique of prolonged perineural femoral nerve blockade in patients with lower extremity occlusive disease allowed to accelerate postoperative recovery period and contributed to the reduction of intensive care unit stay and decreased incidences of perioperative complications.