Pasychnyk G. Optimization of anesthesia and perioperative intensive care in patients with pituitary adenoma.

The research work is dedicated to theoretical generalization and clinical base of necessity to improve the quality of anesthesiological assistance to patients with pituitary adenoma according to developed new methods of evaluation and correction of psychosomatic and neuroendocrine patients' status during preoperational period, optimization of anesthesiological provision of operations and postoperative intensive care. Comprehensive study of endocrine, somatic, psycho-emotional, hemodynamic, microcirculatory and metabolic components of homeostasis in patients with pituitary adenoma in different variants of hormoneproductive tumor is conducted. It is defined that in patients with hormonally non-active tumors and prolactinoma the normmetabolic type of homeostasis and normdynamic method of its provision is formed; at adrenokortykotropinoma - hypometabolic type of homeostasis and hypodynamic regimen of blood circulation, and in patients with somatotropinoma - hypometabolic type of homeostasis and hyperdynamic method of its provision. Variants of optimal preoperational correction of homeostasis, pathogenetically based deliberate options of premedication, induction of anesthesia in patients depending on the variants of metabolism and regimen of blood circulation regulation are developed. Based on perioperative EEG-monitoring of the degree of consciousness suppression, time index, and also energy metabolism in the studied patients, the efficacy of applying of intravenious propofol and inhalation sevoflurane anesthesia during these operations is proved. Postoperative intensive care of patients operated on pituitary adenoma of hypophysis is optimized.