Postoperative prolonged epidural analgesia using disposable elastomeric pumps in elderly patients after spinal neurosurgery

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Abstract

BACKGROUND: Postoperative pain is a significant problem in patients that causes various complications.

AIM: To evaluate the efficacy and safety of prolonged epidural analgesia using

disposable elastomeric pumps in elderly patients undergoing spinal neurosurgery and its comparison with the traditional method of postoperative analgesia in 80 patients.

MATERIALS AND METHODS: Hemodynamic parameters were recorded and the efficiency of pain relief and nature of postoperative complications were assessed in comparable groups. The concentration of interleukin-6 (IL-6) and IL-2 were determined.

RESULTS: In the group with prolonged epidural analgesia with 0.2% ropivacaine solution, an adequate level of analgesia was achieved in 92% of the patients. The revealed changes in the blood serum levels of cytokines IL-6 and IL-2 may indicate a balanced response of the immune system in the group with prolonged epidural analgesia.

CONCLUSIONS: Prolonged epidural analgesia using disposable elastomeric pumps provides complete pain relief for patients and correction of individual links of the surgical stress response.

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About the authors

Alla V. Solenkova

National Medical Research Center of Neurosurgery named N.N. Burdenko, Ministry of Health of the Russian Federation

Author for correspondence.
Email: asolenkova@mail.ru
ORCID iD: 0000-0001-7081-2950
SPIN-code: 3274-6730

MD, PhD, DSc

Russian Federation, 16, ul. 4-ya Tverskaya-Yamskaya, Moscow, 125047

Andrey Yu. Lubnin

National Medical Research Center of Neurosurgery named N.N. Burdenko, Ministry of Health of the Russian Federation

Email: lubnin@nsi.ru
ORCID iD: 0000-0003-2595-5877

DMSc, MD, PhD, DSc, professor

Russian Federation, 16, ul. 4-ya Tverskaya-Yamskaya, Moscow, 125047

Olga N. Ivanova

National Medical Research Center of Neurosurgery named N.N. Burdenko, Ministry of Health of the Russian Federation

Email: oivanova@nsi.ru
ORCID iD: 0000-0003-1253-8337
Russian Federation, 16, ul. 4-ya Tverskaya-Yamskaya, Moscow, 125047

Nikolay A. Konovalov

National Medical Research Center of Neurosurgery named N.N. Burdenko, Ministry of Health of the Russian Federation

Email: NKonovalov@nsi.ru
ORCID iD: 0000-0002-9976-948X
SPIN-code: 9436-3719

MD, PhD, DSc

Russian Federation, 16, ul. 4-ya Tverskaya-Yamskaya, Moscow, 125047

Vasiliy A. Korolishin

National Medical Research Center of Neurosurgery named N.N. Burdenko, Ministry of Health of the Russian Federation

Email: vkorolishin@mail.ru
ORCID iD: 0000-0002-1727-5102
SPIN-code: 2798-1078

MD, PhD

Russian Federation, 16, ul. 4-ya Tverskaya-Yamskaya, Moscow, 125047

Evgeniy S. Brinyuk

National Medical Research Center of Neurosurgery named N.N. Burdenko, Ministry of Health of the Russian Federation

Email: brinya88@mail.ru
ORCID iD: 0000-0001-6184-7481
SPIN-code: 3381-3193
Russian Federation, 16, ul. 4-ya Tverskaya-Yamskaya, Moscow, 125047

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Supplementary files

Supplementary Files
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1. Fig. 1. Hemodynamic parameters in groups. a) dynamics of average blood pressure at the research stages, b) dynamics of heart rate at the research stages. * p <0,05 between groups.

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2. Fig. 2. Pain at rest and when moving according to visual analog scale

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3. Fig. 3. Dynamics of IL-6 values in groups at the research stages

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4. Fig. 4. Values of plasma concentrations of cytokines (IL-6, IL-2) at the research stages during multilevel decompression and stabilization operations

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