УДК 616.832-009.614
E.D. MAMYROV
Pavlodar branch of Semey State Medical University, Republic of Kazakhstan
THE TECHNIQUE OF MONOLATERAL SPINAL ANESTHESIA WITH THE USE OF ELECTRONEUROSTIMULATION
Monolateral spinal anesthesia (MSA) is accompanied by less number of disorders of the central nervous system and respiratory complications due to sympathetic blockade on only one side. At the same time, the technique of performing anesthesia is not enough effective and safe.
The purpose of the study. To develop the technique of unilateral spinal anesthesia (MSA), which would be more efficient, safer and economical compared to already known USA technique.
Material and methods. The study involved 39 patients divided into 2 groups. In the 1st control group which included 22 patients, group II 17 patients, respectively. All the patients were involved in unilateral vascular and traumatologic operations. In the control group a standard needle for spinal anesthesia with sizes from 22 to 25 G was used. In the main group there were used special insulated needles for ENS - Stimuplex 21-22G, special device for ENS - Stimuplex-HNS-12 (B. Braun) and Pajunk (Germany).
Results and discussion. All patients in the main group received a motor response at the time of puncture of Dura mater and doctor determined the location of the needle tip according to the median line. The frequency of intraoperative complications was higher for patients of the 1st group compared to the second group. Thus, 6 (27,2%) patients of the control group experienced the hypotension below 80 mm of mercury after the onset of anesthesia, 2 (9%) - nausea and 4 (18,1%) - vomiting. In the main group, 4 (18,3%) patients experienced the hypotension below 80 mm of mercury, 1 (4,5%) - nausea.
Conclusions. In comparison with the known techniques, MSA with ENS allows to determine the location of the needle tip in the subarachnoid space according to the median line at the moment of puncture of the dura mater and more accurately introduce a local anesthetic. Thus, the application of the MSA technique with the ENS usage, increases the efficacy and safety of patients. An innovative patent of the NIIS of the Republic of Kazakhstan was obtained.
Key words: regional anaesthesia, spinal anesthesia, electroneurostimulation, unilateral, needle, injection, local anaesthetic, subarachnoid space, vascular surgery, hypotension, post dural puncture headache, intrathecal space, spinal cord, baricity, monolateral, unilateral.