Advances in laparoscopic technology have significantly improved surgical outcomes by reducing operative trauma, enhancing recovery speed, and minimizing postoperative complications. These benefits are particularly crucial for elderly patients, who often have multiple comorbidities affecting perioperative management. Laparoscopic cholecystectomy is a common minimally invasive procedure, but in elderly patients, it presents challenges due to intraoperative hemodynamic fluctuations caused by pneumoperitoneum and patient positioning. This study aims to compare the effects of combined multimodal anesthesia (CMA) incorporating epidural block with mechanical ventilation versus total intravenous anesthesia (TIVA) on hemodynamic stability in elderly patients. The research analyzes intraoperative cardiovascular parameters, including blood pressure (BP), heart rate (HR), and cardiac output, as well as postoperativerecovery markers.
Advances in laparoscopic technology have significantly improved surgical outcomes by reducing operative trauma, enhancing recovery speed, and minimizing postoperative complications. These benefits are particularly crucial for elderly patients, who often have multiple comorbidities affecting perioperative management. Laparoscopic cholecystectomy is a common minimally invasive procedure, but in elderly patients, it presents challenges due to intraoperative hemodynamic fluctuations caused by pneumoperitoneum and patient positioning. This study aims to compare the effects of combined multimodal anesthesia (CMA) incorporating epidural block with mechanical ventilation versus total intravenous anesthesia (TIVA) on hemodynamic stability in elderly patients. The research analyzes intraoperative cardiovascular parameters, including blood pressure (BP), heart rate (HR), and cardiac output, as well as postoperativerecovery markers.
№ | Муаллифнинг исми | Лавозими | Ташкилот номи |
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1 | Pardayev S.K. | ! | Samarkand State Medical University |
2 | Kasparova G.A. | ! | Samarkand State Medical University |
№ | Ҳавола номи |
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1 | 1.Аваков В.Е. с соавт. Мониторинг гемодинамики при эндоскопических холецистэктомиях в процессе различных вариантов мидазоламовой анестезии. Эндоскопическая хирургия. —1997. -No1.-С. 13-14.2.АлиевМ.А., Сексенбаев Д.С., Доскалиев Ж.А., Сексенбаев Б.Д., Тлегенова Г.У. Лапароскопическаяхолецистэктомия при калькулезном холецистите у больных с сопутствующими заболеваниями // Эндоскопическая хирургия. -2009.-No4.-С. 24-263.Бобринская И.Г., Левите Е.М, Феденко В.В. Прогноз и коррекция нарушений, связанных с пневмоперитонеумом. Российский медицинский журнал. —2001. —No6. —С. —31-34. 4.Зильбер А.П. Анестезия у больных с сопутствующими заболеваниями и осложняющими состояниями// Руководство по анестезиологии / Под ред. А.А.Бунятяна. -М.: Медицина, 2014. -С.602-634. 5.Goldman L. Cardiac risk in noncardiac surgery: an update / L. Goldman // Anesth. Anaig., 1985. -No 80. -p. 810. 6.Harju J., Juvonen P., Eskelinen M., Misttinen P., Paakkonen M. Mini laparotomy cholecystectomy versus laparoscopic cholecystectomy: a randomized study with special reference to obesity // Surg. Endosc. 2006. -Vol. 20. -P. 583-586. 7.Mehta N, Gupta S, Sharma A, Dar MR. Thoracic combined spinal epiduralanesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency. Local Reg Anesth 2015; 8:101–04.8.Putensen-Himmer J., Putensen C., Lammer H. Comparing of postoperative respiratory function after laparoscopy отlaparotomy for cholecystectomy. Anaesthesiology. -1992. —No77. —P. 675.9.Richardson J.D., Trinkle J.K. Hemodynamic and respiratory alterations with increased intraabdominal pressure. J. Surg. Res. -1976. —No 20. -P. 401-404. 10.Schein M., Wittmann D.H., Aprahamian C.C., et al. The abdominal compartment syndrome: The physiological and clinical consequences of elevated intra-abdominal pressure. J. Amer. Coll. Surg. —1995.-Vol. 180.-P. 745-753.11.Targarona E.M., Gracia E., Garriga J. et al. Prospective randomized trial comparing conventional laparoscopic colectomy withhand-assisted laparoscopic colectomy: applicability, immediateclinical outcome, infl ammatory response, and cost. Surg. Endosc. -2002. —No 16(2). —P. 234—239. |