PULMONARY GAS EXCHANGE IN NEUROAXIAL ANESTHESIA

Abstract

The study of a pulmonary gas exchange in condition of neuroaxial anesthesia in 245 patients divided into four groups depending on the upper level of the sensor block from Th 12 to Th 4 was done. It was established that in 40% of the cases an acute respiratory failure (ARF) of the first and second degree developed. It was found out that the decrease of a heart index at neuroaxial anesthesia is primary and leads to pulmonary hypoperfusion and the disturbance of ventilation and perfusion relation, arterial hypoxemia till ARF development. There has been suggested the method of correction of hemodynamic changes by dopamine infusion with the speed 5-6 mkg/kg/min to support the inotropic function of myocardium under constant control of a heart index and intravenous introduction of mesaton 0.8-1.2 mkg/kg/min to support vascular tonus. There were no cases of arterial hypoxemia or ARF, this fact allowed to consider the method of prophylaxis and correction of pulmonary gas exchange at neuroaxial anesthesia to be quite effective.