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.
1. Гельфанд Б.Р. [и др.]. Унилатеральная субарахноидальная анестезия при операциях на венах нижних конечностей // Вестник Российского государст-венного медицинского университета. 2011. №3. C.39–42.
2. Козырев А.С. [и др.]. Монолатеральная спинальная анестезия у детей // Травматология и ортопедия России. 2010. № 2(56). С. 13–17.
3. Константинова Г.Д., Донская Е. Д., Эпштейн С. Л. Хирургическое лечение варикозной болезни нижних конечностей у лиц старше 60 лет в стационаре краткосрочного пребывания // Новости хирургии. 2012. № 4 (16). C. 50–58.
4. Корнеев С.В. Применение односторонней спинальной анестезии при операциях на нижних конечностях в травматологии // Вестник хирургии Казахстана. 2011. № 3 (27). C. 36–37.
5. Лахин Р.Е. [и др.]. Экспериментальное исследова-ние гидродинамики гипербарического раствора, вводимого через спинальные иглы различных типов и калибров // Анестезиологическая и реаниматологи-ческая помощь больным. 2013. №2(10). C.3–8.
6. Лахин Р.Е. [и др.]. Гидродинамика гипербари-ческого раствора на модели «Стеклянная спина», вводимого через спинальные иглы различных типов и калибров // Вестник анестезиологии и реаниматологии. 2013. № 3 (10). C. 33–39.
7. Лахин Р.Е. Селективная спинальная анестезия у больных, раненых и пострадавших. Дис. докт. мед. наук. - СПб.: 2016. 224 C.
8. Соатов А.Р., Семенихин А.А. Пути снижения операционно-анестезиологического риска при операциях на нижних конечностях у гериатрических больных с недостаточностью кровообращения // Регионарная анестезия и лечение острой боли. 2013. № 1 (7). C. 33–37.
9. Шадурский Н.Н., Кузьмин В.В., Вощинин А.В. Методика односторонней эпидуральной анестезии при эндопротезировании коленного сустава // Регионарная анестезия и лечение острой боли. 2012. №4(6). C. 22–28.
10. Abou-ElWafa H.S., El-Metwaly A.A.M., El-Gilany A.-H. Lower Limb Varicose Veins among Nurses: A Single Center Cross-Sectional Study in Mansoura, Egypt // Indian Journal of Occupational and Environmental Medicine. 2020. № 3 (24). C. 172–177.
11. Adigun O.O., Reddy V., Varacallo M. Anatomy, Back, Spinal Cord // Treasure Island (FL): StatPearls Publishing, 2022. C. 1-8.
12. Ahmed W.U.R. et al. Genome-wide association analysis and replication in 810,625 individuals with varicose veins // Nature Communications. 2022. № 1 (13). C. 1-11.
13. Allegri M. et al. Italian Registry of Complications associated with Regional Anesthesia (RICALOR). An incidence analysis from a prospective clinical survey // Minerva Anestesiologica. 2016. № 4 (82). C. 392–402.
14. Augustin M. et al. Double-blind, randomized, intraindividual comparison study of the efficacy of prilocaine and lidocaine in tumescent local anesthesia // Dermatology (Basel, Switzerland). 2010. № 3 (221). C. 248–252.
15. Baldini G. et al. Postoperative urinary retention: anesthetic and perioperative considerations // Anesthesiology. 2009. № 5 (110). C. 1139–1157.
16. Barbosa F. T. et al. Neuraxial anaesthesia for lower-limb revascularization (Review) // Cochrane Database of systhematic reviews. 2013. № 7. C. 1-43.
17. Basurto Ona Xavier. et al. Drug therapy for preventing post-dural puncture headache // Cochrane Database of Systematic Reviews. 2013. № 2. C. 1-70.
18. Beilin B. et al. The effects of postoperative pain management on immune response to surgery // Anesthesia and Analgesia. 2003. № 3 (97). C. 822–827.
19. Bergmann I. et al. Selective unilateral spinal anaesthesia for outpatient knee arthroscopy using real-time monitoring of lower limb sympathetic tone // Anaesthesia and Intensive Care. 2015. № 3 (43). C. 351–356.
20. Bican O., Minagar A., Pruitt A.A. The spinal cord: a review of functional neuroanatomy // Neurologic Clinics. 2013. № 1 (31). C. 1–18.
21. Bier A. Versuche über Cocainisirung des Rückenmarkes 1899. C. 361–369.
22. Blomgren L. et al. Recurrent varicose veins: incidence, risk factors and groin anatomy // European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery. 2004. № 3 (27). C. 269–274.
23. Broadbent C.R. et al. Ability of anaesthetists to identify a marked lumbar interspace // Anaesthesia. 2000. № 11 (55). C. 1122–1126.
24. Büttner B. et al. Einseitige Spinalanästhesie // Der Anaesthesist. 2016. № 11 (65). C. 847–865.
25. Büttner B. et al. Unilateral spinal anesthesia : Literature review and recommendations // Der Anaesthesist. 2016. № 11 (65). C. 847–865.
26. Cappelleri G. et al. Spinal anesthesia with hyperbaric levobupivacaine and ropivacaine for outpatient knee arthroscopy: a prospective, randomized, double-blind study. // Anesthesia and analgesia. 2005. № 1 (101). C. 77–82.
27. Casati A. et al. Randomized comparison between sevoflurane anaesthesia and unilateral spinal anaesthesia in elderly patients undergoing orthopaedic surgery. // European journal of anaesthesiology. 2003. № 8 (20). C. 640–646.
28. Casati A. et al. A prospective, randomized, double-blind comparison of unilateral spinal anesthesia with hyperbaric bupivacaine, ropivacaine, or levobupivacaine for inguinal herniorrhaphy // Anesthesia and Analgesia. 2004. № 5 (99). C. 1387–1392.
29. Casoni P. et al. Great saphenous vein surgery without high ligation of the saphenofemoral junction // Journal of Vascular Surgery. 2013. № 1 (58). C. 173–178.
30. Cicekci F. et al. Is unilateral spinal anesthesia superior to bilateral spinal anesthesia in unilateral inguinal regional surgery? // Middle East journal of anaesthesiology. 2014. № 6 (22). C. 591–596.
31. Cockett F.B. Diagnosis and surgery of high-pressure venous leaks in the leg; a new overall concept of surgery of varicose veins and venous ulcers // British Medical Journal. 1956. № 5006 (2). C. 1399–1403.
32. Defty C. et al. A comparison of the complication rates following unilateral and bilateral varicose vein surgery // European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery. 2008. № 6 (35). C. 745–749.
33. Ding Y. et al. Combined low dose local anesthetics and opioids versus single use of LA for transurethral urological surgery: A meta-analysis // Nigerian Journal of Clinical Practice. 2015. №2(18). С. 256-262.
34. Eklöf B. et al. Revision of the CEAP classification for chronic venous disorders: consensus statement // Journal of Vascular Surgery. 2004. № 6 (40). C. 1248–1252.
35. Engel A.F., Davies G., Keeman J.N. Preoperative localisation of the saphenopopliteal junction with duplex scanning // European Journal of Vascular Surgery. 1991. № 5 (5). C. 507–509.
36. Enk D. et al. Success rate of unilateral spinal anesthesia is dependent on injection flow // Regional Anesthesia and Pain Medicine. 2001. № 5(26). C. 420–427.
37. Esmaoglu A. et al. Bilateral vs. unilateral spinal anesthesia for outpatient knee arthroscopies. // Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2004. № 2 (12). C. 155–158.
38. Evans C.J. et al. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study // Journal of Epidemiology and Community Health. 1999. № 3 (53). C. 149–153.
39. Fatemi A. Tumescent Local Anesthesia with Articaine // Springer. 2006. C. 80–82.
40. Fitzgerald J. P. et al. Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta-analysis of randomised controlled trials // Anaesthesia. 2020. № 1 (75). C. 109–121.
41. Frostell A. et al. A Review of the Segmental Diameter of the Healthy Human Spinal Cord // Frontiers in Neurology. 2016. (7). C. 1-13.
42. Fukaya E. et al. Clinical and Genetic Determinants of Varicose Veins // Circulation. 2018. № 25 (138). C. 2869–2880.
43. Gao L. et al. Effects of prophylactic ondansetron on spinal anesthesia-induced hypotension: a meta-analysis // International Journal of Obstetric Anesthesia. 2015. № 4 (24). C. 335–343.
44. Gerheuser F., Roth A. Epidural anesthesia // Der Anaesthesist. 2007. № 5 (56). C. 499–523.
45. Ghaleb A., Khorasani A., Mangar D. Post-dural puncture headache // International Journal of General Medicine. 2012. (5). C. 45–51.
46. Hajibandeh S. et al. Meta-Analysis of Spinal Anesthesia Versus General Anesthesia During Laparoscopic Total Extraperitoneal Repair of Inguinal Hernia // Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2020. № 4 (30). C. 371–380.
47. Hamdan A. Management of varicose veins and venous insufficiency // JAMA. 2012. № 24 (308). C. 2612–2621.
48. Hart J.R., Whitacre R.J. Pencil-point needle in prevention of postspinal headache // Journal of the American Medical Association. 1951. № 7(147). C. 657–658.
49. Heim D. et al. Resecting the great saphenous stump with endothelial inversion decreases neither neovascularization nor thigh varicosity recurrence // Journal of Vascular Surgery. 2008. № 5 (47). C. 1028–1032.
50. Holme J. B., Skajaa K., Holme K. Incidence of lesions of the saphenous nerve after partial or complete stripping of the long saphenous vein // Acta Chirurgica Scandinavica. 1990. № 2 (156). C. 145–148.
51. Imbelloni L. Spinal hemianesthesia: Unilateral and posterior // Anesthesia: Essays and Researches. 2014. №3 (8). C. 270-276.
52. Jawien A. The influence of environmental factors in chronic venous insufficiency // Angiology. 2003. №1 (54). C. 19-31.
53. Klein J.A. The Tumescent Technique for Lipo-Suction Surgery // The American Journal of Cosmetic Surgery. 1987. № 4 (4). C. 263–267.
54. Klein J.A. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction // The Journal of Dermatologic Surgery and Oncology. 1990. № 3 (16). C. 248–263.
55. Klein J.A. Tumescent technique chronicles. Local anesthesia, liposuction, and beyond // Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery. 1995. № 5 (21). C. 449–457.
56. Kopacz D.J., Neal J.M., Pollock J.E. The regional anesthesia «learning curve». What is the minimum number of epidural and spinal blocks to reach consistency? // Regional Anesthesia. 1996. № 3 (21). C. 182–190.
57. Kosem B. An unusual complication of anesthesia: Unilateral spinal myoclonus // Ağrı - The Journal of The Turkish Society of Algology. 2016. № April (29). C. 90–91.
58. Kumar Singh T. et al. Unilateral Spinal Anaesthesia for Lower Limb Orthopaedic Surgery Using Low Dose Bupivacaine with Fentanyl or Clonidine: A Randomised Control Study // Journal of Anesthesia & Clinical Research. 2014. № 12 (05). C. 1-5.
59. Lees T. et al. Prospective audit of surgery for varicose veins // The British Journal of Surgery. 1997. № 1 (84). C. 44–46.
60. Leon-Casasola O.A. Clinical outcome after epidural anesthesia and analgesia in high-risk surgical patients // Regional Anesthesia. 1996. № 6 Suppl (21). C. 144–148.
61. Li L. et al. Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis // BMC anesthesiology. 2020. № 1 (20). C. 1-12.
62. Linton R.R. The communicating veins of the lower leg and the operative technic for their ligation // Annals of Surgery. 1938. № 4 (107). C. 582–593.
63. Lurie F. et al. The 2020 update of the CEAP classification system and reporting standards // Journal of Vascular Surgery. Venous and Lymphatic Disorders. 2020. № 3 (8). C. 342–352.
64. Magar J.S., Bawdane K.D., Patil R. Comparison of Efficacy and Safety of Unilateral Spinal Anaesthesia with Sequential Combined Spinal Epidural Anaesthesia for Lower Limb Orthopaedic Surgery. // Journal of Clinical and Diagnostic Research. 2017 Jul, Vol-11(7). C. 17-20
65. Mamyrov Y.D. et al. Optimized Method of Unilateral Spinal Anesthesia: A Double-blind, Randomized Clinical Study // Anesthesiology and Pain Medicine. 2023. № 2(13). C. 1-8.
66. Maxson L.H. Spinal Anesthesia: Its Technique, Records, and Results // California and Western Medicine. 1933. № 5 (39). C. 292–297.
67. Moosavi Tekye S.M., Alipour M. Comparison of the effects and complications of unilateral spinal anesthesia versus standard spinal anesthesia in lower-limb orthopedic surgery // Brazilian Journal of Anesthesiology (English Edition). 2013. (110). C. 1-4.
68. Moriarty A. Pediatric epidural analgesia (PEA) // Paediatric Anaesthesia. 2012. № 1 (22). C. 51–55.
69. Mutlu M., Turkmen S. The effect of different anaesthesia techniques on postoperative pain and hospital discharge in varicose vein surgery // Cardiovascular Journal of Africa. 2022. № 2 (33). C. 46–49.
70. O’Dwyer M.J., Owen H.C., Torrance H.D.T. The perioperative immune response // Current Opinion in Critical Care. 2015. № 4 (21). C. 336–342.
71. Oertel R., Rahn R., Kirch W. Clinical pharmacokinetics of articaine // Clinical Pharmacokinetics. 1997. № 6 (33). C. 417–425.
72. Oh A.Y. et al. Influence of the timing of administration of crystalloid on maternal hypotension during spinal anesthesia for cesarean delivery: preload versus coload // BMC Anesthesiology. 2014. № 1 (14). C. 1-5.
73. O’Hare J.L. et al. A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up // Journal of Vascular Surgery. 2008. № 3 (48). C. 669–673.
74. Oliveira R. de Á. et al. Evidence for varicose vein treatment: an overview of systematic reviews // Sao Paulo Medical Journal = Revista Paulista De Medicina. 2018. № 4 (136). C. 324–332.
75. Ostad A., Kageyama N., Moy R. L. Tumescent anesthesia with a lidocaine dose of 55 mg/kg is safe for liposuction // Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery. 1996. № 11 (22). C. 921–927.
76. Overbeck K., Zubrzycka D., Stansby G. Bilateral varicose vein surgery in the UK // Phlebology. 2006. №1 (21). С. 12-15.
77. Pannier-Fischer F., Rabe E. Epidemiology of chronic venous diseases. Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete. 2003. № 11 (54). C. 1037–1044.
78. Perkins J.M.T. Standard varicose vein surgery // Phlebology. 2009. (24 Suppl 1). C. 34–41.
79. Pitkänen M.T. et al. Serious complications associated with spinal and epidural anaesthesia in Finland from 2000 to 2009 // Acta Anaesthesiologica Scandinavica. 2013. № 5 (57). C. 553–564.
80. Potapov O.L. Unilateral spinal anesthesia in operations on the kidney and upper third of the ureter. // Klinichna khirurhiia. 2009. № 10. C. 36–39.
81. Pu X., Sun J.-M. General anesthesia vs spinal anesthesia for patients undergoing total-hip arthroplasty: A meta-analysis // Medicine. 2019. № 16 (98). C. 1-8.
82. Rathmell J.P., Avidan M.S. Patient-Centered Outcomes after General and Spinal Anesthesia // The New England Journal of Medicine. 2021. № 22 (385). C. 2088–2089.
83. Reina M.A. et al. Electron Microscopy of Dural and Arachnoid Disruptions After Subarachnoid Block // Regional Anesthesia and Pain Medicine. 2017. № 6 (42). C. 709–718.
84. Rij A. M. van et al. Neovascularization and recurrent varicose veins: more histologic and ultrasound evidence // Journal of Vascular Surgery. 2004. № 2 (40). C. 296–302.
85. Saifuddin A., Burnett S. J., White J. The variation of position of the conus medullaris in an adult population. A magnetic resonance imaging study // Spine. 1998. № 13 (23). C. 1452–1456.
86. Scholl R., Bekker A., Babu R. Neuroendocrine and Immune Responses to Surgery // The Internet Journal of Anesthesiology. 2012. № 3 (30). C. 1-8.
87. Shadrina A.S. et al. Mendelian randomization analysis of plasma levels of CD209 and MICB proteins and the risk of varicose veins of lower extremities // PloS One. 2022. № 5 (17). C. 1-14.
88. Huo T. et al. Major complications of regional anesthesia in 11 teaching hospitals of China: a prospective survey of 106,569 cases // J. Clin. Anesth. 2016 (31). C. 154–161.
89. Tanasichuk M.A. et al. Spinal hemianalgesia: an evaluation of a method, its applicability, and influence on the incidence of hypotension // Anesthesiology. 1961. № 1 (22). C. 74–85.
90. Tang L. et al. Comparison of Effects between Combined Lumbar-Sacral Plexus Block plus General Anesthesia and Unilateral Spinal Anesthesia in Elderly Patients Undergoing Hip Fracture Surgery: A Pilot Randomized Controlled Trial // Evidence-Based Complementary and Alternative Medicine. 2021. (2021). C. 1-7.
91. Triffterer L. et al. An observational study of the macro- and micro-haemodynamic implications of epidural anaesthesia in children // Anaesthesia. 2017. № 4 (72). C. 488–495.
92. Vuylsteke M.E. et al. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology // European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery. 2015. № 4 (49). C. 432–439.
93. Vuylsteke M.E. et al. The influence of age and gender on venous symptomatology. An epidemiological survey in Belgium and Luxembourg // Phlebology. 2016. № 5 (31). C. 325–333.
94. Vuylsteke M. E. et al. An Epidemiological Survey of Venous Disease Among General Practitioner Attendees in Different Geographical Regions on the Globe: The Final Results of the Vein Consult Program // Angiology. 2018. № 9 (69). C. 779–785.
95. Winterborn R. J. et al. Randomised trial of flush saphenofemoral ligation for primary great saphenous varicose veins // European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery. 2008. № 4 (36). C. 477–484.
96. Winterborn R. J., Corbett C. R. R. Treatment of varicose veins: the present and the future--a questionnaire survey // Annals of the Royal College of Surgeons of England. 2008. № 7 (90). C. 561–564.
97. Yang G. K. et al. Comparison of cyanoacrylate embolization and radiofrequency ablation for the treatment of varicose veins // Phlebology. 2019. № 4 (34). C. 278–283.
98. Youn Y. J., Lee J. Chronic venous insufficiency and varicose veins of the lower extremities // The Korean Journal of Internal Medicine. 2019. № 2 (34). C. 269–283.
99. Yu C. et al. Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies // International Journal of Obstetric Anesthesia. 2021. (47). C. 103-175.
100. Zhang L. et al. Sciatic-femoral nerve block versus unilateral spinal anesthesia for outpatient knee arthroscopy: A meta-analysis // Minerva Anestesiologica. 2015. № 12 (81). C. 1359–1368.
References: [1-9]
1. Gel'fand B.R. et al. Unilateral'naya subarakhnoidal'naya anesteziya pri operatsiyakh na venakh nizhnikh konechnostei [Unilateral subarachnoid anesthesia during operations on the veins of the lower extremities]. Vestnik Rossiiskogo gosudarstvennogo meditsinskogo universiteta [Bulletin of the Russian State Medical University] 2011. № 3. pp. 39-42 [in Russian]
2. Kozyrev A.S. et al. Monolateral'naya spinal'naya anesteziya u detei [Monolateral spinal anesthesia in children]. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of Russia] 2010. № 2(56). pp. 13–17. [in Russian]
3. Konstantinova G.D., Donskaya E.D., Epshtein S.L. Khirurgicheskoe lechenie varikoznoi bolezni nizhnikh konechnostei u lits starshe 60 let v statsionare kratkosrochnogo prebyvaniya [Surgical treatment of varicose veins of the lower extremities in persons over 60 years of age in a short-term hospital]. Novosti khirurgii. [News of surgery] 2012. № 4 (16). pp. 50–58. [in Russian]
4. Korneev S.V. Primenenie odnostoronnei spinal'noi anestezii pri operatsiyakh na nizhnikh konechnostyakh v travmatologii [Use of unilateral spinal anesthesia during operations on the lower extremities in traumatology]. Vestnik khirurgii Kazakhstana. [Bulletin of surgery of Kazakhstan]. 2011. № 3 (27). pp. 36-37 [in Russian]
5. Lakhin R.E. et al. Eksperimental'noe issledovanie gidrodinamiki giperbaricheskogo rastvora, vvodimogo cherez spinal'nye igly razlichnykh tipov i kalibrov [Experimental study of the hydrodynamics of a hyperbaric solution administered through spinal needles of various types and calibers]. Anesteziologicheskaya i reanimatologicheskaya pomoshch' bol'nym [Anesthetic and resuscitation care for patients]. 2013. №2(10). pp.3–8. [in Russian]
6. Lakhin R.E. et al. Gidrodinamika giperbaricheskogo rastvora na modeli «Steklyannaya spina», vvodimogo cherez spinal'nye igly razlichnykh tipov i kalibrov [Hydrodynamics of a hyperbaric solution on the “Glass Back” model, administered through spinal needles of various types and calibers]. Vestnik anesteziologii i reanimatologii [Bulletin of Anesthesiology and Reanimatology]. 2013. № 3 (10). pp. 33–39. [in Russian]
7. Lakhin R.E. Selektivnaya spinal'naya anesteziya u bol'nykh, ranenykh i postradavshikh [Selective spinal anesthesia in patients, wounded and injured]. dis. dokt. med. nauk. - SPb.: 2016. 224 p. [in Russian]
8. Soatov A.R., Semenikhin A.A. Puti snizheniya operatsionno-anesteziologicheskogo riska pri operatsiyakh na nizhnikh konechnostyakh u geriatricheskikh bol'nykh s nedostatochnost'yu krovoobrashcheniya [Ways to reduce operational and anesthetic risk during operations on the lower extremities in geriatric patients with circulatory failure]. Regionarnaya anesteziya i lechenie ostroi boli. [Regional anesthesia and treatment of acute pain]. 2013. №1 (7). pp. 33–37. [in Russian]
9. Shadurskii N.N., Kuz'min V.V., Voshchinin A.V. Metodika odnostoronnei epidural'noi anestezii pri endoprotezirovanii kolennogo sustava [Method of unilateral epidural anesthesia for knee replacement]. Regionarnaya anesteziya i lechenie ostroi boli [Regional anesthesia and treatment of acute pain]. 2012. №4(6). pp.22–28. [in Russian]
Number of Views: 717
Category of articles:
Reviews
Bibliography link
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:
EVIDENCE-BASED NURSING PRACTICE. LITERATURE REVIEW
DEVELOPMENT OF AN ALGORITHM FOR DISPENSARY OBSERVATION OF PATIENTS WHO UNDERWENT CORONARY ARTERY BYPASS GRAFTING
PSYCHOEMOTIONAL STATUS IN PATIENTS WITH CHRONIC HEART FAILURE. LITERATURE REVIEW.
ENDOSCOPIC TREATMENT OF BLEEDING OF THE UPPER GASTROINTESTINAL TRACT.LITERARY REVIEW.
ACTUAL PROBLEMS OF THE USE MODERN INTRAMEDULLARY TELESCOPIC RODS USED IN THE SURGICAL TREATMENT OF OSTEOGENESIS IMPERFECTA IN CHILDREN. REVIEW.