Multimodal combined anaesthesia during lung surgeries in patients with low breathing reserve: 10 clinical surveillances

Abstract

The paper provides the experience of 10 surgeries on lung cancer (5 of them are pneumonectomies) against the severe chronic obstructive lung disease. The surgeries have been conducted under the authors’ multimodal combined anaesthesia with the infusion of fentanyl, ropivakaine and adrenaline into the epidural space. The authors have succeeded to achieve good hemodynamic stability, failing the dangerous decrease of the total peripheral resistance. This notwithstanding, they have achieved high quality of the post-operative anaesthesia (0,63 points after 30 minutes of extubation, on average, according to 10-point scale of pain). The second advantage of this method is that there have been no cases of the residual sedation or respiratory distress. Therefore, the authors have created adequate conditions required to successfully perform surgeries on the lungs by thoracotomy approach that allowed not only to conserving the patients’ extremely low compensation abilities but also creating conditions for free breathing with the left areas of the functionally bad pulmonary tissue. The authors have succeeded to implement the crucial condition - free respiration under clear consciousness with no pain. The post-operative period under continuous three-phase epidural anaesthesia during 3 days was even. All the patients were discharged at a proper time.