FEATURES OF GAS EXCHANGE DURING MULTISTAGE SURGICAL INTERVENTION FOR TRAUMATIC SPINE INJURY

Abstract

Objective. To study gas composition and acid-base balance of blood in the course of multistage surgical intervention for traumatic spine injury. Material and Methods. Gas composition and acid-base balance of blood were analyzed in 51 patients with traumatic spine injuries during multistage surgical treatment in a single operation. Patients were divided into two groups: Group 1 included 26 patients operated on under TIVA with propofol, fentanyl, and еsmeron; and Group 2 included 25 patients operated on under general anesthesia with sevoflurane in low-flow ventilation mode, fentanyl, and еsmeron. Results. In both groups acid-base balance parameters in blood were characterized by unidirectional changes depending on the state of compensated metabolic acidosis. More essential fluctuations in pH, and in the excess or deficit of buffer bases depended on the type of surgical intervention. They were more statistically significant during anterior procedures in condition of open pneumothorax requiring changes in lung ventilation parameters. Values of paO2 and paCO2 remained relatively stable in both groups at the study stages. Conclusion. Main factors determining changes in blood gas parameters during spine surgery are specific features of the anterior fusion procedure and its succession in the course of multistage surgical intervention. Hir. Pozvonoc. 2012;(2):79-86.