International Medical Journal, Vol. 23., Iss. 1, 2017, P. 93−96.
POST-OPERATIVE ANALGESIA IN PATIENTS WITH ESOPHAGEAL CANCER
A. A. Shalimov National Institute of Surgery and Transplantation, Kyiv, Ukraine
The present work investigates development of a new approach to providing postoperative analgesia during surgery for esophageal cancer. To improve the results of surgical treatment of patients with malignant diseases of the esophagus, a method of management of postoperative analgesia was developed and applied in the patients who were performed radical surgery with combined thoracoabdominal approach (Lewis or Garlock−Osawa) and who were administered post−operative anesthesia in the form of thoracic epidural analgesia and thoracic paravertebral block. The patients were performed clinical and laboratory investigations, monitoring of urine output. Intensity of pain was assessed using Visual Analogue Scale and FPORS−scale (four point observer ranking scale). The parameters of acid alkaline and blood gas status, respiratory and hemodynamic performance, clinical and biochemical blood count were evaluated. The proposed method consisted in insertion of 1 catheter at the level of Th5−Th7 before the surgery, and the other during the surgery in the paravertebral space at the level of throracotomy. The improved method of combined postoperative analgesia using thoracic epidural anesthesia and thoracic paravertebral block proved its effectiveness in control of pain and absence of complications such as hypotension and respiratory disorders.
Key words: thoracic epidural anesthesia, thoracic paravertebral block, visual pain scale, esophageal cancer, surgery.