Open AccessCombined anesthesia for off-pump coronary artery bypass grafting in patients with visceral obesity
Author(s) -
М.И. Туровец,
C. М. Шлахтер,
A. M. Streltsova
Publication year - 2020
Publication title -
vestnik anesteziologii i reanimatologii
Language(s) - English
Resource type - Journals
eISSN - 2541-8653
pISSN - 2078-5658
DOI - 10.21292/2078-5658-2020-17-3-17-23
Subject(s) - medicine , intensive care unit , anesthesia , narcotic , artery , cardiopulmonary bypass , incidence (geometry) , bypass grafting , coronary artery disease , surgery , cardiology , physics , optics
The objective: to analyze results of the use of combined anesthesia for coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG) in patients with visceral obesity (VO). Subjects and methods. A randomized study of results of surgical treatment in patients with VO and coronary heart disease who underwent off-pump CABG was conducted. 197 patients were included in the study. The main group ( n = 98) included patients who underwent combined anesthesia (with thoracic epidural analgesia (TEA)) and patients in the control group ( n = 99) underwent total intravenous anesthesia (with narcotic analgesics). Results. In patients from the main group, a significant decrease in the incidence of acute kidney injury ( p = 0.0180), respiratory complications ( p = 0.0177), atrial and ventricular arrhythmias ( p = 0.0029) was recorded. With the use of TEA, the duration of treatment of patients in the intensive care unit ( p = 0.0229) and duration of hospital stay ( p = 0.0419) significantly decreased. Conclusion: The use of combined anesthesia (with TEA) for off-pump CABG in patients with visceral obesity reduces the risk of early postoperative complications, the duration of hospital stay and treatment in the intensive care unit.