Aivardzhi O. Improvement of effectiveness of anesthetic management in septoplasty under combined anesthesia

The dissertation is devoted to substantiation, research and implementation of the optimal variant of anesthesiological support of septoplasty in order to improve perioperative analgesia, optimize hemodynamic control, prevent stress response to surgical trauma, reduce blood loss and increase patient satisfaction. The indicators of 116 patients were investigated and analyzed in the work. According to the results of the work it is established that the proposed variant of anesthesiological support of septoplasty using ANI-monitoring and multimodal approach with the addition of a combination of intravenous paracetamol and dexmedetomidine allows on-line intraoperative assessment of analgesia/nociceptive, to predict the intensity of postoperative pain and achieve optimal analgesia parameters (ANI level at the most traumatic moment was by 42.6% higher than in the control group), hemodynamics (cardiac index at the traumatic moment of surgery was by 36% lower compared to the control group, and mean arterial pressure – by 31.2% also lower than the same value in group "K"), to reduce blood loss (74% less than in the control group) and improve patiens’ comfort and safety (88.9% of respondents rated "Excellent").