Evaluation of the effectiveness of central blockade in pregnant women with mitral stenosis

Abstract

The study was carried out in order to determine the most rational and safest variant of regional anesthesia for abdominal delivery in patients with moderately pronounced mitral stenosis with an area of ​​2.9-2.0 cm ²and decreased coronary reserves. The latter included 51 women. All patients are divided into three equal groups depending on the type of anesthesia. The patients of the 1st group were operated under conditions of spinal anesthesia, the 2nd - under the conditions of epidural anesthesia, the patients of the 3rd group were operated on under the conditions of balanced epidural anesthesia with reduced concentrations of local anesthetic in combination with fentanyl and preventive analgesia. At the stages of anesthesia and surgery, the central and peripheral hemodynamics and the functional state of the sympathoadrenal and hypothalamic-pituitary systems were studied. It was found that the most rational and safe method of pain relief in patients with mitral stenosis and reduced coronary reserves is epidural anesthesia with reduced concentrations of bupivacaine hydrochloride in combination with fentanyl and preventive analgesia.