THE QUESTION OF CHOOSING THE OPTIMAL OPTION OF ANESTHESIOLOGICAL MANAGEMENT WHEN CARRYING OUT RECONSTRUCTIVE PLASTIC SURGERY IN PATIENTS WITH POST-CLEAR CONTRACTURES OF THE FACE, NECK AND CHEST
Keywords:
reconstructive plastic surgery, methods of anesthesia, regional anesthesia, oxygen pressureAbstract
56 patients aged 16 to 50 were under the experience of reconstructive plastic surgery for post-burn contractures of the face, neck and chest. According to the anesthetic manual we used, the patients were divided into 2 groups: in the first (1) group - 27 patients (48.2%) used regional anesthesia (blockade of the cervical plexus and 3 branches of the trigeminal nerve). In the second (2) group of 29 patients (51.8%), reconstructive plastic surgery (RPO) was performed under the conditions of total intravenous anesthesia with benzodiazepines, ketamine, fentanyl with myoplegia arduan in standard age dosages.
Oxygen pressure in the soft tissue (PTKO2) of the operated area was examined using a Clark-type transducer using percutaneous contact polarography. The temperature was measured with an electric thermometer with fixation of the central T1C (oral cavity) and peripheral T2C (subclavian region), as well as the affected area T3C.
Compared temperature gradients of the flaps at the stages in the groups indicate (indirectly) a microcirculation with regional anesthesia better than TVA. Our obtained results according to the data of thermometry of the flaps at the stages of surgical intervention are quite consistent with those changes in oxygen tension in the tissues of the flap (PTKO2) in the patients examined by us. This results are less complicated in the operated tissues rather than other proven anesthesia methods when using regional anesthesia.
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Статья поступила в редакцию 10.05.2024; одобрена после рецензирования 21.06.2024; принята к публикации 29.06.2024.
The article was submitted 10.05.2024; approved after reviewing 21.06.2024; accepted for publication 29.06.2024.
