Critical Incidents and Safety of Xenon Anesthesia in Abdominal Surgery

A.Yu. Kulikov1, O.V. Kuleshov1, 2, K.M. Lebedinskiy2

1 Saint-Petersburg Multiprofile Сenter, Saint-Petersburg

2 Ilya I. Mechinkov North-Western State Medical University, Saint-Petersburg

For correspondence: Kulikov Alexey Yurievich — anaesthetist, Saint-Petersburg,; e-mail: alexeykulikov1987@yandex.ru

For citation: Kulikov AYu, Kuleshov OV, Lebedinskiy KM. Critical Incidents and Safety of Xenon Anesthesia in Abdominal Surgery. Intensive Care Herald. 2016;3:22–26.


Xenon is the most promising anesthetic of the XXI century, in many ways close to the ideal. The aim of this study was to investigate the safety of the balanced general and combined xenon anesthesia by analysis of intraoperative critical incidents (CI). A retrospective data analysis of anesthesia with extended hemodynamic monitoring in 80 patients, underwent elective abdominal surgery, was done. Depending on the anesthesia’s type and basic inhalation agent (xenon or sevoflurane), patients were divided into 3 groups. The structure and frequency of intraoperative CI was observed. Under balanced general and combined xenon anesthesia main hemodynamic incidents were decrease in cardiac output and bradycardia, while in the sevoflurane group decrease of cardiac output and hypotension prevailed. The frequency of other CI did not differ significantly. Xenon anesthesia is safe and effective in patients undergoing abdominal surgery.

Keywords: xenon, sevoflurane, general anesthesia, critical incident, safety

Received: 09.08.2016


References

  1. Aitkenhead A.R., Smith G. (eds) Textbook of anaesthesia (3rd). N-Y: Churchill Livingstone/Elsevier, 1996.
  2. Кровообращение и анестезия. Под ред. К.М.Лебединского.СПб.: Человек, 2012: 567. [Lebedinskiy K.M. (ed) Krovoobrashchenie i anesteziya. (Anesthesia and blood circulation.) Saint-Petersburg: Chelovek Publ.; 2012: (In Russ)]
  3. Щеголев А.В., Цыганков К.А., Лахин Р.Е. и др. Анализ частоты критических инцидентов при плановых оперативных вмешательствах на органах брюшной полости. Вестник Российской военно-медицинской академии. 2016; 1(53): 29–32. [Shchegolev A.V., Tsygankov K.A., LakhinR.E. et al. Critical incidents frequency analysis in elective abdominal surgery. Vestnik Rossiiskoi Voenno-Meditsinskoi akademii. 2016; 1(53): 29–32. (In Russ)]
  4. Руденко М.И. Сочетанная анестезия в абдоминальной хирургии у больных пожилого возраста. Вестник интенсивной терапии. 2010; 2: 27–32. [Rudenko M.I. Combined anesthesia in elderly patients undergoing abdominal surgery. Vestnik intensivnoi terapii. 2010; 2: 27–32. (InRuss)]
  5. Al Tmimi L., Van Hemelrijck J., Van de Velde M. et al. Xenon anaesthesia for patients undergoing off-pump coronary artery bypass graft surgery: a prospective randomized controlled pilot trial. Br. J. Anaesth. 2015; 4(115): 550–559.
  6. Langesaeter E., Rosseland L.A., Stubhaug A. Continuous invasive blood pressure and cardiac output monitoring during cesarean delivery: a randomized, double-blind comparison of low-dose versus high-dose spinal anesthesia with intravenous phenylephrine or placebo infusion. Anesthesiology. 2008; 109(5): 856–863.
  7. Рылова А.В., Лубнин А.Ю. Ксеноновая анестезия по закрытому контуру: печальный и радостный опыт. Обзор аппаратуры. Вестник интенсивной терапии. 2008; 4: 17–22. [Rylova A.V., Lubnin A.Y. Xenon anesthesia on closed cicuit: a sad and pleasurable experience. Vestnik intensivnoi terapii. 2008; 4: 17–22. (In Russ)]
  8. Nicholson G., Hall G.M., Burrin J.M. Peri‐operative steroid supplementation. Anaesthesia. 1998; 53: 1091–109