Abstract
The development of neuropathy in the postoperative period is a rare complication but it may be associated with regional anesthesia. The objective of the prospective observational study was to detect subclinical signs of neuropathy after abdominal surgery. In Group 1 (n = 80), epidural anesthesia with ropivacaine and combined general anesthesia were used. In Group 2 (n = 95), only general combined anesthesia was applied. The assessment was performed in 3 and 7 days after the surgery. Monofilament testing and assessment of temperature sensitivity were used for detection of sensory neuropathy. No neurological disorders leading to the development of paresis, paralysis, or active complaints were found out. Subclinical neuropathy after abdominal surgery was detected in both groups. After regional block with ropivacaine, the incidence of neuropathy on the 3rd day after surgery during monofilament testing was higher (7.5%) versus general anesthesia (2.1%; p = 0.048). The results of monofilament testing were similar to the results of the cold test (Group 1 - 8.75%, Group 2 - 2.1%; p = 0.046). The detected neuropathy was transient, on the 7th day its manifestations regressed, residual signs of subclinical neuropathy persisted in 1 patient only.
Highlights
Возникновение невропатии в послеоперационном периоде является редким осложнением, но может быть связано с проведением регионарной анестезии
The development of neuropathy in the postoperative period is a rare complication but it may be associated with regional anesthesia
Monofilament testing and assessment of temperature sensitivity were used for detection of sensory neuropathy
Summary
The development of neuropathy in the postoperative period is a rare complication but it may be associated with regional anesthesia. The objective of the prospective observational study was to detect subclinical signs of neuropathy after abdominal surgery. Subclinical neuropathy after abdominal surgery was detected in both groups. After regional block with ropivacaine, the incidence of neuropathy on the 3rd day after surgery during monofilament testing was higher (7.5%) versus general anesthesia (2.1%; p = 0.048). For citations: Lakhin R.E., Gemua I.А., Bogomolov B.N., Levshankov А.I. Epidural anesthesia with ropivacaine causes transient subclinical neuropathy. Perretta et al (2017), целенаправленно осматривая пациентов, оперируемых на верхних конечностях, выявили, что после регионарной блокады субклиническая невропатия возникает в 2 раза чаще по сравнению с общей анестезией [9]. Для выявления расстройств чувствительности у пациентов после регионарной анестезии решили обследовать пациентов без предшествующей невропатии. Монофиламентное тестирование потенциально может выявить небольшие сенсорные расстройства, которые могут не вызывать жалоб и могут быть не замечены пациентом или без целенаправленного исследования [1, 7]
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