COMBINED SPINAL-EPIDURAL ANESTHESIA FOR ABDOMINAL HYSTERECTOMY IN PATIENTS WITH COPD

Abstract

Introduction: All patients with chronic obstructive pulmonary disease (COPD) are with increased risk for intra and postoperative complications during abdominal surgery. In our study we present another approach in anesthetic management in these highly risk patients. Methods: We analyzed 20 patients, ASA III, scheduled for elective abdominal hysterectomy. After appropriate preoperative preparation in every patient epidural catheter was placed on Th12 - L1 or L1-L2 level, while spinal punction with standard spinal anesthesia was performed on lower levels. We evaluate basic hemodynamic parameters, patients’ satisfaction and postoperative pulmonary complications.Results: All hemodynamic parameters showed decrease in the first 30 minutes and then constant flow until the end of surgery. 4 patients developed postoperative pulmonary infection, and ended well. All patients were very satisfied with anesthesia procedure.Conclusion: Combined spinal-epidural anesthesia provides good hemodynamic stability, large patients’ satisfaction with fewer postoperative pulmonary complications in patients with COPD. Encouraging this anesthesia technique might increase the safety margin of surgery in patients with severe pulmonary diseases.