Despite significant advances in global anesthesiology in recent years, the effectiveness of perioperative analgesia during reconstructive and aesthetic breast surgery has room for optimization. There is an urgent need to determine the path of safe analgesia for the development of side effects from various organ systems, in particular, possible cognitive consequences (Zheng JW, 2017) and quality of life disorders (Satomoto M., 2018), changes in central and cerebral hemodynamics (Qin G. et al., 2017).
The method of anesthesia, the drugs used in the field of plastic surgery of the breast have a number of features compared to the anesthesia in the practice of general surgery. In particular, there are some contradictions in low-flow inhalation anesthesia regarding the use of sevoflurane during plastic surgery: on the one hand, some researchers emphasize its protective effect in ischemic-reperfusion injury (Claroni C. et al., 2016), better than in others. injection of propofol, immunotropic effect (Lim JA et al., 2018); on the other hand, some authors during the use of sevoflurane find certain disorders of higher nervous activity, general well-being, side effects (Chen H.P. et al., 2013; Erb T.O. et al., 2017). Also gaining attention are the growing techniques of regional blockades, such as interfascial blocks PECS 1 and PECS 2 (Blanco R. et al., 2012), the effectiveness of which in comparison with standard methods of analgesia for different types of interventions on the breast is subject to further discussion (Najeeb HN et al., 2018).
Thus, the problem of anesthesia for breast prosthetics is relevant, and the assessment of the effectiveness of perioperative analgesia using low-flow inhalation anesthesia with sevoflurane and improve regulation, correction of vital functions, cognitive function, psychological, vegetative status.
Improving the effectiveness of perioperative analgesia during reconstructive and aesthetic surgery on the mammary glands is the subject of research in advanced medical institutions around the world (Baida VG et al., Kyiv, Ukraine; de Paula PR et al., USA; Enekvist B. et al., 2015, Sweden; Erb TO et al., 2017, Switzerland; Chen HP et al., Taiwan; Besir A. et al., Turkey; Qin G. et al., 2017, China; Satomoto M., 2018 , Japan, etc.).
Purpose of work
Improving the quality and safety of anesthesia during reconstructive and aesthetic surgery on the breast by improving the method of perioperative anesthesia using low-flow inhalation anesthesia with sevoflurane and modified interfascial blockades.
Research objectives
1. Carry out a comparative analysis of the effectiveness of anesthesia during reconstructive and aesthetic surgery on the mammary glands;
2. To determine the features of metabolic status, the course of the postoperative period in persons who underwent low-flow inhalation anesthesia with sevoflurane in combination with opioid analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs) during reconstructive and aesthetic surgical procedures;
3. To investigate the effectiveness and safety of the modified PECS unit during reconstructive and aesthetic surgical interventions on the mammary glands;
4. Develop a protocol for evaluating the effectiveness of anesthesia during reconstructive and aesthetic surgery on the mammary glands.
Object of research. Pain syndrome; postoperative nausea and vomiting; cognitive state of women during reconstructive and aesthetic surgical interventions on the mammary glands.
The subject of research
Clinical, psychosocial, cognitive, neurofunctional, metabolic parameters; means of anesthesiological support of reconstructive and aesthetic surgical interventions on mammary glands.
