Use of concomitant anesthesia (endotracheal anesthesia and femoral nerve block) in cardiac surgery: a prospective, cross-sectional study

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Abstract

BACKGROUND: Regional anesthesia reduces pain impulse transmission, which reduces hormonal and metabolic responses to operational stress. No studies have reported on the use of combined anesthesia, such as endotracheal anesthesia and femoral nerve block, in cardiac surgery.

OBJECTIVE: To determine the efficacy of combined anesthesia by analyzing the cortisol, glucose, and lactate levels in cardiac surgery.

MATERIALS AND METODS: Prospective cross-sectional study was conducted. The study included 60 cardiac surgery patients. The patients were divided into two groups: group 1, with endotracheal anesthesia and femoral nerve blockade, and group 2, with endotracheal anesthesia (control group). All patients underwent aortocoronary bypass grafting under artificial circulation conditions. Cortisol, glucose, and lactate levels at the five stages of the perioperative period were investigated.

RESULTS: Data analysis showed that the cortisol level of patients with combined anesthesia was significantly 1.2 times lower (p=0.042) than that in the control group in step 2. Glucose levels were significantly lower in the combined anesthesia group by 1.28 times (p=0.0017) than in the control group in step 4 and significantly lower by 1.2 times (p=0.0016) in step 5. Additionally, lactate level was significantly lower in the combined anesthesia group than in the control group in step 4 by a factor of 1.3 (p=0.03) and in step 5 by a factor of 1.35 times (p=0.005).

CONCLUSION: The determination of cortisol, glucose, and lactate levels can be used as a component of endocrine-metabolic anesthesiological monitoring when performing cardiac surgery under artificial circulation conditions. Stable parameters of endocrine-metabolic monitoring were established using both anesthesia methods. The use of femoral nerve block in combined anesthesia reduces stress response to surgery.

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About the authors

Tatyana I. Klepcha

Mogilev Regional Clinical Hospital

Author for correspondence.
Email: tatsianaklepcha@gmail.com
ORCID iD: 0000-0002-4426-0213

MD, anesthesiologist-resuscitator

Belarus, Mogilev

Vladimir A. Dudko

Mogilev Regional Clinical Hospital; Vitebsk State Order of Peoples’ Friendship Medical University

Email: vladimirdudko@mail.ru
ORCID iD: 0000-0002-5959-5454

MD, anesthesiologist-resuscitator, department head, senior lecturer

Belarus, Mogilev; Vitebsk

Artur L. Lipnitskiy

Mogilev Regional Clinical Hospital; Vitebsk State Order of Peoples’ Friendship Medical University

Email: lipnitski.al@gmail.com
ORCID iD: 0000-0002-2556-4801
SPIN-code: 4478-4748

MD, Cand. Sci. (Medicine), anesthesiologist-resuscitator, department head, associate professor

Belarus, Mogilev; Vitebsk

Alexey V. Marochkov

Mogilev Regional Clinical Hospital; Vitebsk State Order of Peoples’ Friendship Medical University

Email: marochkov@mail.ru
ORCID iD: 0000-0001-5092-8315
SPIN-code: 2477-0659

MD, Dr. Sci. (Medicine), anesthesiologist-resuscitator, professor

Belarus, Mogilev; Vitebsk

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2. Fig. 1. Cortisol levels in both groups during the study phases.

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