THE CHOICE OF THE MOST OPTIMAL METHOD OF ANESTHESIA FOR OPERATION ON THE LOWER EXTREMITY VESSELS
Introduction. Varicose veins (VV) are characterized by saphenous, dilated, tortuous veins measuring three millimeters or more, involving the saphenous veins, saphenous tributaries, or superficial veins of the legs. Manifestations of varicose veins range from limited discomfort in the legs to swelling and non-healing ulcers, sometimes leading to disability. The frequency and severity of these symptoms are directly related to age and gender. Due to the high variability of localization and the degree of involvement of the venous network, there are various methods of surgical treatment of this pathology, as well as a variety of methods of anesthesia with their inherent positive and negative qualities.
Aim. To analyse literature reflecting modern ideas about the prevalence of varicose veins of the lower extremities, methods of surgical treatment and a reasonable choice of the safest and most effective method of anesthesia.
Search strategy. The search for publications was carried out in the following databases: PubMed, Embase, Scopus, Web of Science, e-Library and Cyberleninka. Key queries included the following terms: chronic venous insufficiency, varicose veins, phlebectomy, crossectomy, regional anesthesia, spinal anesthesia, epidural anesthesia, unilateral spinal anesthesia. The search depth was 20 years, works from earlier years that were of high scientific value on this topic were also included.
Results and conclusions. The degree of quality of pain relief during VV surgeries, its duration, and comfort for the patient and operating team are highly variable. The key factors are the number of complications associated with dural puncture, patient satisfaction and time to recovery from anesthesia. The use of a choice of modern methods of anesthesia, such as unilateral spinal anesthesia (USA), allows us to avoid most of the adverse effects of spinal anesthesia, while USA supplemented with electrical nerve stimulation increases the safety of anesthesia, has high selectivity, and allows to anesthetize only one lower limb of the patient.
Yernar D. Mamyrov1, https://orcid.org/0000-0003-4070-2165
Daulet U. Mamyrov1, https://orcid.org/0000-0001-7887-1736
Gulzhanat E. Jakova2, https://orcid.org/0000-0002-9479-5419
Yoshihiro Noso3, https://orcid.org/0000-0003-3477-1260
Marat K. Syzdykbaev4, https://orcid.org/0000-0002-0561-4111
1 Pavlodar Branch of NCJSC “Semey Medical University”, Department of Emergency Medicine, Obstetrics and Gynecology, Pavlodar, Kazakhstan;
2Department of Surgery, Pavlodar Branch of NCJSC Semey Medical University, Pavlodar, Kazakhstan
3 Hiroshima International University, Department of Health Services Management, Hiroshima, Japan;
4 NCJSC “Semey Medical University”, Department of Surgery, Anesthesiology and Reanimatology, Semey, Republic of Kazakhstan.
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Mamyrov Y.D., Mamyrov D.U., Jakova G.E., Noso Yo., Syzdykbaev M.K. The Choice of the Most Optimal Method of Anesthesia for Operation on the Lower Extremity Vessels: A Narrative Review // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 4, pp. 213-223. doi 10.34689/SH.2023.25.4.026Related publications:
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