EPIDURALNA ANESTEZIJA U MODERNOJ HIRURGIJI I PREVENCIJA MOGUĆIH KOMPLIKACIJA
Ključne reči:
epiduralna anestezija, hirurgija, analgezijaApstrakt
Moderna anesteziološka praksa je omogućila rapidan napredak moderne hirurgije. Poslednjih godina epiduralna anestezija (EA) postala je jedna od najpopularnijih anestezijskih procedura za izvodjenje operativnih zahvata iz domena: vaskularne, kardiotorakalne i abdominalne hirurgije.
Ova vrsta anestezije ubraja se u centralne neuroblokove, a nastaje ubrizgavanjem rastvora lokalnog anestetika u epiduralni prostor torakalnog, lumbalnog ili sakralnog dela. Dodatnim uvodjenjem katetera u periduralni prostor otvara se mogućnost kontinuiranog analgetskog dejstva u dužem vremenskom periodu.
Zbog svojih prednosti EA se često koristi samostalno ili u kombinaciji sa drugim anesteziološkim procedurama u kardiovaskularnoj hirurgiji, posebno u perifernoj vaskularnoj hirurgiji.
Prednosti, koje pozitivno utiču na ishod tretmana su: simpatička blokada koja rezultuje u perifernoj vazodilataciji, sprovodni blok koji omogućava kompletnu analgeziju i smanjuje odgovor na neuro-endokrini stres.
EA značajno smanjuje verovatnoću postoperativnih komplikacija (mučnina, povraćanje, bol) koji mogu da odlože otpust ambulantno lečenih pacijenata.
Epiduralna anestezija je bezbedna metoda, ali, kao i kod svih medicinskih procedura, neželjeni efekti i komplikacije se mogu ponekad desiti. U savremenoj anesteziološkoj praksi važno je prevenirati ih, prepoznati ih na vreme i pravovremeno i adekvatno lečiti kako bi se izbegle još teže posledice.
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