The problem of choosing methods of anesthesia and a decline in perioperative pharmacological upload in patients with tumors of chiasmatic-sellar region of patients operated by endoscopic endonasal transsphenoidal surgery

A.B. Kurnosov, A.V. Schmigelskiy, P.L. Kalinin, M.A. Kutin, D.V. Phomichev, O.I. Scharipov

Federal State Budgetary Scientific Institution «Scientific and Research Institute of Neurosurgery named by an acad. N.N. Burdenko», Moscow

For citation: Kurnosov AB, Schmigelskiy AV, Kalinin PL et. al. The problem of choosing methods of anesthesia and a decline in perioperative pharmacological upload in patients with tumors of chiasmatic-sellar region of patients operated by endoscopic endonasal transsphenoidal surgery. Intensive Care Herald. 2016;1:21–26.


Currently, there is an actively developed method of removing tumors of chiasmo-sellar region by endoscopic endonasal transsphenoidal approach, which is considered to be less traumatic and is well tolerated by patients, whereby it is possible to operate the older patients, and patients with clinically significant somatic pathology. Given this, the problem of choosing the method of anesthesia and the decline in perioperative pharmacological load on a patient in such operations, is essential. In order to achieve improved results of anesthetic management were investigated 200 patients (a group with general anesthesia – 125 patients, and a group where general anesthesia combined with block anesthesia – 75 patients); there was carried out a successful attempt to improve the anesthetic technique by a combination of general and block anesthesia (bilateral anesthesia of pterygopalatine fossa) and a significant decrease of pharmacological stress on the patient was obtained. In addition, it has been considered such a problem, as the fight against post-operative pain. For this purpose has been allocated two subgroups of 20 patients (the subgroup, where the patients received only the total anesthesia, and the subgroup where the patients received general anesthesia combined with block), which analyzed the severity of postoperative pain on a visual analog scale of pain during the day. Therefore, the best results were in the subgroup of patients where the combined anesthesia was used – there was a significant decrease in pain intensity on a background of lower consumption of Lornoxicamum.

Keywords: anesthesia during performance of transsphenoidal operations, endoscopic endonasal transsphenoidal approach, postsurgical pain syndrome, a decline in pharmacological load, block anesthesia in transsphenoidal surgery.


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