Medical and Health Sciences | Article | Published 2023-12-23

The effect of intrapleural analgesia on the external respiration function of patients after surgical interventions in the hepatobiliary zone.

Authors:

Anvar Tahirov

Publisher: American Journal of Medicine and Medical Sciences 2023, 13(12): 2007-2011
Collection: American Journal of Medicine and Medical Sciences
DOI: DOI: 10.5923/j.ajmms.20231312.40
Keywords: Analgesia, Intrapleural analgesia, External respiration, Liver echinococectomy, Cholecystectomy

Abstract

Abstract The aim of the study was to determine the effect of intrapleural analgesia on the function of external respiration of patients in the postoperative period. Introduction. Postoperative pain sensations represent only the visible part of the iceberg, being the root cause of a pathological postoperative syndrome development, which negatively affects the respiratory system. The main trend of clinical research in recent years in this area is the use of the principle of multimodality of pain protection with an emphasis on preventive (before injury and pain) protection. Material and methods. We observed 93 patients diagnosed with liver echinococosis and acute calculous cholecystitis, who were performed traditional liver echinococectomy and cholecystectomy from 2018 to 2022. The mean age of the examined patients was 52±3.4 years. The patients were divided into 2 groups depending on the type of anesthetic provision. In Group 1, the opioid analgesic promedol, 20 mg IM, was used for the treatment of postoperative pain; in group 2, patients for this purpose were administered intrapleural lidocaine 1% at a dose of 2.5 mg/kg upon request. Results. In Group 1, at the stages of surgery, there was an increase in the total peripheral vascular resistance by 15.1% (P<0.05) and a decrease in the indicators of one-time and one-minute heart performance. The main indicators of central hemodynamics of patients in Group 2 of patients at the stages of surgery were stable. Discussion. The use of intrapleural analgesia helps to normalize the patency of small bronchi and improves the patency of large and medium bronchi, creates prerequisites for the realization of muscular effort during breathing and coughing. Clinically, this was manifested by the disappearance of pain syndrome, relief of sputum discharge. Conclusion. Intrapleural analgesia using local anesthetics lidocaine 1% at a dose of 2.5 mg / kg is the most affordable and adequate method of postoperative anesthesia for surgical interventions in the hepatobiliary zone. Intrapleural administration of lidocaine improves the parameters of respiratory mechanics, which promotes the implementation of patients' active postoperative rehabilitation program

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