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• W2891608173 abstract "The introduction of the article drew attention to the increasing popularity and relevance of spinal anesthesia in the various fields of surgery, traumatology, orthopedics, urology due to high efficiency, reliable antinociceptive protection, ease of implementation, low material costs, the possibility of using anesthesia with anxiolysis, or without it. This property of neuraxial anesthesia techniques is especially important in emergency anesthesiology, as it allows preserve the natural protection of the upper respiratory tract, making anaesthetic support more safe. Despite these advantages of spinal anesthesia, there is indicated on the negative aspects arising from sympathetic block for neuraxial techniques of anesthesia. Such undesirable, and sometimes potentially dangerous factors are excessive hypotension and bradycardia, which requires correction in the perioperative period. Suggested the possibility of using cholinolytic and sympathomimetic properties of acupan (nefopam) for the prevention and leveling the above effects of sympathetic block. Materials and Methods. A study based on personal experience of the author of this article, for what there are taken identical groups of adult patients underwent surgery for acute appendicitis, inguinal and umbilical hernias, both planned and in urgent procedure under spinal anesthesia, in 2010–2012. Patients of the study group (n = 27) 15–20 minutes before performing spinal anesthesia we administered intramuscularly nefopam or acupan 20 mg. Patients from control group (n = 28) didn’t receive the drug. We investigated systolic blood pressure, pulse, initiation and the rate of infusion of alpha-adrenergic agonist mezaton, need for correction of bradycardia with atropine. Results of the Study. In the study group three male patients (11.1 %) and one woman (3.7 %) did not require vasopressor infusion. In the control group pharmacological correction of sympathetic block was necessary to all patients. In the first group mezaton infusion began from 8–20th minute after induction of spinal anesthesia. The second group needed much more early infusion of vasopressor (2nd — 8th minute). Rate of mezaton administration was significantly lower in patients of the study group (3.9 ± 1.7 mcg/min) than in control patients (16.1 ± 4.0 mcg/min). Heart rate was more stable in patients of the first group (62–94 per 1 minute). In the second group bradycardia (heart rate less than 60 per 1 minute) caused by sympathetic block and potentiated by reflex negative chronotropic influence of mezaton, required repeated injections of atropine in 19 (67.9 %) patients. Conclusions. Thus, the administration of acupan (nefopam) before spinal anesthesia provides a clear and clinically significant antihypotensive and positive chronotropic effects in the sympathetic block induced by spinal anesthesia. It enables to recommend it not only for the prevention of perioperative shivering, but also to reduce the hypotensive and bradiaritmic effects of neuraxial anesthesia." @default.
• W2891608173 created "2018-09-27" @default.
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• W2891608173 date "2014-01-01" @default.
• W2891608173 modified "2023-09-23" @default.
• W2891608173 title "Hemodynamic Effects of Acupan and Nefopam in Terms of Prevention and Correction of Hypotension and Bradycardia Caused by Sympathetic Block in Spinal Anesthesia" @default.
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