THE INFLUENCE OF EPIDURAL ANALGESIA ON HEMOSTATIC POTENTIAL AFTER ABDOMINAL OPERATIONS IN PATIENTS WITH OBESITY
DOI:
https://doi.org/10.31379/2411.2616.11.1.3Keywords:
obesity, laparoscopic surgery, hemostasis, epidural analgesiaAbstract
Introduction. Current recommendations for the prevention of venous thromboembolism (VTE) in obese patients have a low level of evidence. That’s why the use of other techniques of influence on hemostatic potential (GP) is actual. Aim. To evaluate the effect of epidural analgesia (EA) on hemostatic system parameters after laparoscopic operations in obese patients. Material and methods. GP parameters were measured in 52 patients with BMI>30 kg/m2 using the method of low-frequency piezoelectric thromboelastography (LPTEG). The initial GP level was determined and its changes were compared on the 3rd day after surgery between the group of total intravenous anesthesia (TBA, n=26) and EA-group (n=25). Statistical analysis was conducted using Statistica for Windows version 6.0. Results. The initial level of GP didn’t differ significantly between the study groups. In TBA-group hypercoagulation and inhibition of fibrinolysis with a moderate decrease in platelet aggregation were present on the 3rd day after surgery (p<0.05). In EA-group there was an improvement in coagulation and fibrinolysis but aggregation rates reached the lower limit of the norm (p<0.05). Conclusion. Perioperative use of EA in abdominal laparoscopic surgery of patients with obesity helps to normalize coagulation and fibrinolytic GP components and reduces the aggregation of formed blood elements.
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