Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector4281410.17816/RA42814ArticlesСтатьиResearch ArticleDo anesthesiologists need epidural anesthesia and do surgeons need an anesthesiologist?Нужна ли анестезиологам эпидуральная анестезия и нужен ли хирургам анестезиолог? Мысли вслух, рожденные при чтении трудов профессора Н. РаваляOvechkinAlexei M.ОвечкинАлексей Михайлович

MD, PhD, DSc, professor, Head of the Department of anesthesiology and resuscitation, I.M. Sechenov First Moscow State Medical University

доктор медицинских наук, профессор, заведующий кафедрой анестезиологии и реаниматологии, ГБОУ ВПО «Первый московский государственный медицинский университет им. И.М. Сеченова»

ovechkin_alexei@mail.ruI.M. Sechenov First Moscow State Medical UniversityГБОУ ВПО «Первый московский государственный медицинский университет им. И.М. Сеченова»15092016103VOL 10, NO3 (2016)ТОМ 10, №3 (2016)15516424082020Copyright ©; 2016, Eco-VectorCopyright ©; 2016, ООО "Эко-Вектор"2016Eco-VectorООО "Эко-Вектор"https://rjraap.com/1993-6508/article/view/42814

Presented paper reviews up-to-date often contradictive concepts about the role of epidural anesthesia in anesthesiological support of patients undergone major surgery. The author performed critical analysis of the arguments of the opponents of the wide use of epidural analgesia who propose to substitute the epidural anesthesia with minimally invasive techniques in particular infiltration analgesia with local anesthetics. The article includes convincing evidence in favour of continuous epidural anesthesia remains the method of choice for open major thoracic and abdominal surgery especially in patients from high risk groups.

Данная статья представляет собой обзор современных зачастую противоречивых представлений о роли эпидуральной анальгезии в анестезиологическом обеспечении пациентов, перенесших обширные хирургические вмешательства. Проведен критический анализ аргументов противников широкого применения эпидуральной анальгезии, предлагающих заменить ее малоинвазивными методиками, в частности инфильтрационной анальгезией местными анестетиками. Приведены убедительные доказательства в пользу того, что продленная эпидуральная анальгезия продолжает оставаться методом выбора при открытых обширных торакальных и абдоминальных операциях, особенно у пациентов групп высокого риска.

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