Stručni rad
https://doi.org/10.20471/acc.2019.58.s1.14
Regional Anaesthesia in Thoracic and Abdominal surgery
Vesna Novak-Jankovič
orcid.org/0000-0002-5786-1499
; Clinical department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
Jasmina Markovič-Božič
orcid.org/0000-0001-7412-7395
; Clinical department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
Sažetak
Surgical procedure causes tissue damage which activates systemic inflammatory response and leads to changes in endocrine and metabolic system. Anaesthesia and pain can further disrupt immune performance. Regional anaesthesia causes afferent nerve blockade and in this way
mediates immune protection. Thoracic epidural analgesia is the cornerstone of pain relief in thoracic and abdominal surgery. Alternatively thoracic paravertebral block can be used with less side effects and good analgesic properties. Drugs that interfere with blood coagulation obstruct the use of central regional blocks. Surgery has also changed recently from open to minimally invasive. Also pain treatment
for this procedures has changed to less aggressive, systemic or locoregional techniques. It was shown that transversus abdominis plane block and epidural analgesia have the same effect on postoperative
pain, but transversus abdominis plane block was better regarding hemodynamic stability and hospital stay. Multimodal approach combining regional and systemic analgesia is currently the most appropriate perioperative pain management strategy. More studies should be done to give recommendations.
Ključne riječi
regional anaesthesia; thoracic surgery; abdominal surgery
Hrčak ID:
224332
URI
Datum izdavanja:
1.7.2019.
Posjeta: 2.668 *