Sukhodolya Anatolyi Ivanovuch, Chubar Ivan Viktorovuch and Sukhodolya Lyudmula Ivanivna*

Department of Medicine, Anestesiology, Vinnitsa National Medical University by M.I. Pyrogof, Ukraine

*Corresponding Author: Sukhodolya Lyudmula Ivanivna, Department of Medicine, Anestesiology, Vinnitsa National Medical University by M.I. Pyrogof, Ukraine.

Received: June 29, 2023; Published: July 05, 2023

Abstract

Video-assisting thoracoscopic interventions have significant advantages over open thoracotomy procedures, including reduction of surgical pain, improvement of postoperative pulmonary function, reduction of mortality, reduction of hospital stay, but the optimal choice of anesthesia for these interventions remains relevant and not fully resolved issues of thoracic surgery.

The Purpose of the Work: Is to analyze the effectiveness of anesthesiological support for thoracoscopic operations on the lungs with a focus on unilateral vagosympathetic blockade and high epidural anesthesia.

Materials and Research Methods: 45 patients were included in the work: in group A (23 people) thoracospopic intervention was performed using high epidural anesthesia, in group B (22 people) - using unilateral paravertebral vagosympathetic blockade.

Research Results: In the case of epidural anesthesia for thoracoscopic interventions, cardiohemodynamic parameters are characterized by a tendency to hypotension and tachycardia (p < 0.05), compared with patients who have been used with vagosympathetic blockade

At 6 and 12 hours after the intervention, the subjective assessment of VAS pain was greater in the epidural group (p < 0.05). When assessing the need for additional intravenous administration of analgesics in the first 24 hours of the postoperative period, the number of patients in the epidural anesthesia group reached 35.0%, in the vagosympathetic block group - 14.0% (RR - 2.55 [0.77-8.41], OR - 3.38 [0.76-15.0], respectively).

Conclusions: Unilateral Vagosympathetic blockade according to Vishnevsky during thoracoscopic operations is not inferior in effectiveness of the analgesic effect of epidural anesthesia, while accompanied by a more stable level of cardiohemodynamics, a longer duration of analgesic effect and less need for intravenous administration of non-narcotic analgesics in the postoperative period.

 Keywords: Video-assisted Thoracoscopic Surgery (VATS); Anesthesia

References

1. Bowness JS., et al. “International consensus on anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia”. Regional Anesthesia and Pain Medicine 47.2 (2022): 106-112.
2. Campos JH and Peacher D. “Choosing the best method for postoperative regional analgesia after video-assisted thoracoscopic surgery”. The Journal of Cardiothoracic and Vascular Anesthesia 34.7 (2020): 1877-18
3. Forero M., et al. “The erector spinae plane block: A novel analgesic technique in thoracic neuropathic pain”. Regional Anesthesia and Pain Medicine 41 (2016): 621-62
4. Hernandez-Vaquero D., et al. “Survival After Thoracoscopic Surgery or Open Lobectomy: Systematic Review and Meta-Analysis”. The Annals of Thoracic Surgery 111 (2020): 302-3
5. Hong JM., et al. “A prospective double-blinded randomized control trial comparing erector spinae plane block to thoracic epidural analgesia for postoperative pain in video-assisted thoracic surgery”. Saudi Medical Journal 44.2 (2023): 155-163.
6. Jack JM., et al. “The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review”. Anaesthesia 75 (2020): 1372–13
7. Kingma BF., et al. “Paravertebral catheter versus Epidural analgesiain Minimally invasive Esophageal resectio N: a randomized controlled multicentertrial (PEPMEN trial)”. BMC Cancer 20.1 (2020): 142.
8. Pakpirom J., et al. “Real-time ultrasound-guided versus anatomic landmark-based thoracicepi dural placement: aprospective, randomized, superioritytrial”. BMC Anesthesiology 22.1 (2022): 198.

Citation

Citation: Sukhodolya Lyudmula Ivanivna., et al. “Anesthesiological Support of Thoracoscopic Operations: Vagosympathetic Blockade and High Epidural Anesthesia”.Acta Scientific Medical Sciences 7.8 (2023): 17-22.

Copyright

Copyright: © 2023 Sukhodolya Lyudmula Ivanivna., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.