Comparative Evaluation of General and Regional Anesthesia Methods in Trauma Surgeries

The risk of complications of anaesthesia is significantly increased in some circumstances specific to emergency patients with pelvic and lower limb injuries. Therefore, in recent years, anaesthesiologists have given preference to regional anaesthesia in operations on pelvic organs and lower extremities.

AIM OF THE STUDY. Comparative evaluation of the methods of general and regional anaesthesia in operations for pelvic and lower limb injuries.

MATERIAL AND METHODS. The data of 101 patients aged from 21 to 78 years, operated in the early posttraumatic period, were included in the study. In group 1 (27 patients) multicomponent endotracheal anaesthesia was used, patients of group 2 (16 patients) were operated under epidural anaesthesia. Patients of the 3rd group (36 patients) underwent surgical intervention under subarachnoid anaesthesia. Group 4 (22 patients) included patients operated under spinal anaesthesia — bupivacaine combined with morphine hydrochloride in a dose of 0.07–0.08 mg.

RESULTS. The most adequate method of postoperative analgesia was the method used in patients of group 4. A single injection of bupivacaine 10–15 mg in combination with morphine (0.08–0.1 mg/kg) provided rapid-onset, adequate, long-lasting (24–72 hours) analgesia without hemodynamic depression. Respiration and SpO₂ were adequate, patients were in a light sedation (level II) and a state of emotional calm and comfort.

CONCLUSION. Spinal anaesthesia with bupivacaine combined with morphine hydrochloride at a dose of 0.07–0.08 mg is the method of choice of anaesthetic aid in orthopedic trauma surgeries, which provides good analgesia and hemodynamic stability with adequate spontaneous breathing of the patient during surgery.

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