COMPARISON OF ANESTHESIA AND PERIOPERATIVE ANALGESIA OPTIONS IN ENDOSCOPIC SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY

Abstract

Patients with morbid obesity have an increased sensitivity of the respiratory center to opioids, which leads to an increased incidence of respiratory diseases, which dictates the need to limit the use of opioids in the structure of anesthesia. Purpose of the trial. Comparison of the impact of anesthesia options with minimal use of opioids during the perioperative period. Materials and methods. A randomized trial of 59 patients with a body mass index > 35 kg/m2, which was performed endoscopic sleeve gastectomy. Depending on the type of anesthesia, patients are divided into two groups. In the 1st group (n-30), the operation was performed under conditions of combined anesthesia based on low-flow inhalation of desflurane in combination with prolonged epidural analgesia (PEA) with of ropivacaine in group 2 (n-29), the operation was performed under conditions of combined anesthesia based on low flow inhalation of desflurane in combination with a combination with an infusion of the analgesic-sympatholytic solution. The indicators of the adequacy of anesthesia, central and peripheral hemodynamics, monitoring of neuromuscular conduction, the efficiency of postanesthesia recovery and the quality of postoperative analgesia were studied. Results and Conclusion. It was revealed that surgical intervention in conditions of low-flow inhalation anesthesia on the basis of desflurane in combination with PEA ropivacaine promotes faster postnanaesthesia recovery and effective postoperative analgesia.