- IRMS - Nicolae Testemitanu SUMPh
- 1. COLECȚIA INSTITUȚIONALĂ
- Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova
- Culegere de postere
Please use this identifier to cite or link to this item:
http://hdl.handle.net/20.500.12710/12693
Title: | Hemodynamic stability of the opioid free anesthesia versus tiva anesthesia techinque in minimum invasive gynecological surgery: pilot study |
Authors: | Manastirschi, Stanislav |
Keywords: | opioid free anesthesia;TIVA;hemodynamic stability;minimally invasive surgery |
Issue Date: | Oct-2020 |
Publisher: | Universitatea de Stat de Medicină şi Farmacie "Nicolae Testemiţanu" |
Abstract: | Introduction
General anesthesia is based on 3 major components:
hypnosis, muscular relaxation and antinociception.
Principal intraoperator index of suficient antinociception is
hemodinamic stability (HR & BP), which can be objectively
majuried during surgery.
Historicaly antinociception were achived by using of opioids
(act on enkephalinic system), which have a lot of adverse
effects (PONV, ileus, hyperalgesia, opioid tolerance). The
general intravenous anesthesia technique without opioids
(OFA) has been developed and studied since 2015. The
expected benefit is avoidance of immediate and lasting
adverse effects of opioids, while maintaining the quality and
safety of the classic TIVA techinque of anesthesia.
In OFA antinociception is achived by using of Lidocaine
(acts on VGSC, muscarinic cholin-ergic and NMDA
receptors), Dexmedetomedine (acts on alpha-2 adrenergic
receptors), MgSO4 (NMDA receptors), Ketamine (NMDA
receptors) and NSAIDs (inhibits COX-1 or COX-2).
Purpose
Comparison of intraoperative hemodynamic stability in
gynecologic minimally invasive surgery, provided by TIVA
versus OFA anesthesia techniques.
Material and Methods
Prospective, randomized study. Research Ethics
Committee approved. Signed informed agreement. The
basic hemodynamic parameters were recorded: systolic
(SBP), diastolic (DBP) and mean (MAP) blood pressure,
heart rate (HR). Statistical test: t-Student unpaired
bicaudal. Statistical software: IBM SPSS Statistics v. 22.
Data are presented as avarage value and standard
deviation
Results
47 young adult patients ASA I-II admited for scheduled
interventions (22 - TIVA, 25 – OFA) enroled. OFA vs.
TIVA. SBP=122.1±11.7 mmHg vs. 124.2±11.7 mmHg
(p=0.57);DBP = 82,2±8,9 mmHg vs. 81,7±9,0 mmHg
(p=0,759); MAP=94.2±8.1 mmHg and 94.6±9.9 mmHg
respectively (p = 0.9); HR=74.6±11.3 bpm vs. 80.1±9.1
bpm (p = 0.096). Adverse haemodynamic events
(deviations ± 15% from pre-induction period) were not
observed.
Conclusion
The OFA anesthesia technique ensures an intraoperative
hemodynamic stability similar to the TIVA anesthesia
technique. OFA can be considered a safe anesthesia
technique from this point of view. |
URI: | http://repository.usmf.md/handle/20.500.12710/12693 |
Appears in Collections: | Culegere de postere
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