[Haemostasis disturbances as the component of the surgical stress-response and possibilities of their correction].

OBJECTIVE

An estimation of haemostasis parameters in the major abdominal surgery in comparision with surgical stress-response markers depending on anaesthesia and analgesia technique.

METHODS

120 patients scheduled to undergo elective low-abdominal surgery were allocated to receive either general anaesthesia (n=40) or combined (general + epidural (n=40) or general + spinal (n=40)) anaesthesia. Postoperative analgesia, glucose, cortisol and cytokine levels, as well as coagulation, fibrinolysis, thrombocyte aggregation parameters were estimated.

RESULTS

The epidural anaesthesia provided better postoperative analgesia. However both spinal and epidural anaesthesia show comparable correction of surgical stress-response markers. Also both types of regional anaesthesia reduced hypercoagulation expression and prevented fibrinolysis activation. This resulted in a reduction in the hemotransfusion frequency

CONCLUSION

Hemostasis changes can be considered as a component of the surgical stress-response. The role of intraoperative regional anaesthesia is much more significant, than postoperative analgesia.