Analysis of hemodynamics indicators during laparoscopic cholecystectomy under epidural anesthesia

Aim. To assess hemodynamic changes during the use of epidural anesthesia in laparoscopic cholecystectomy.

Materials and methods. The study included 184 patients who underwent surgery for cholelithiasis, with epidural anaesthesia in 105 cases and combined general anaesthesia in 79 cases. The majority of patients were female, 163 (88.6%), and 21 (11.4%) were male. The age of the patients ranged from 21 to 88 years. Anaesthetic risk was assessed according to the ASA (American Society of Anesthesiologists) classification. The epidural space was punctured in the sitting position between vertebrae Th8-Th11.

Results. Patients were divided into two groups according to the chosen method of anaesthesia and haemodynamic characteristics. In the first group, laparoscopic cholecystectomy was performed under epidural anaesthesia. This group was further divided into two subgroups according to haemodynamic parameters: patients with a normokinetic type of circulation (20 individuals) and those with a hypokinetic type of circulation (19 individuals).

The second group consisted of patients undergoing laparoscopic cholecystectomy under general endotracheal anaesthesia. The baseline haemodynamic status of these patients was characterised by a normokinetic type of circulation.

Conclusion. A key advantage of epidural anaesthesia is the maintenance of spontaneous breathing throughout the operation. This allows adequate compensation for the adverse effects of capnoperitoneum in laparoscopic surgery

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