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Lopushkov A.V.

Volgograd State Medical University

Turovets M.I.

Volgograd State Medical University

Popov A.S.

Volgograd State Medical University

Zyubina E.N.

Volgograd State Medical University

Burchuladze N.Sh.

Volgograd State Medical University

Stroganova E.P.

Volgograd State Medical University

Streltsova A.M.

Volgograd State Medical University

Kikteva O.S.

Volgograd State Medical University

Vorobyova A.A.

Volgograd Medical University

Mikhin I.V.

Volgograd State Medical University

Anesthetic strategy for reducing the risk of infection in patients with pancreatic necrosis

Authors:

Lopushkov A.V., Turovets M.I., Popov A.S., Zyubina E.N., Burchuladze N.Sh., Stroganova E.P., Streltsova A.M., Kikteva O.S., Vorobyova A.A., Mikhin I.V.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2023;(6): 58‑67

DOI: 10.17116/anaesthesiology202306158

Read: 1352 times

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Table of contents

ANESTHETIC STRATEGY FOR REDUCING THE RISK OF INFECTION IN PATIENTS WITH PANCREATIC NECROSIS
ANESTHETIC STRATEGY FOR REDUCING THE RISK OF INFECTION IN PATIENTS WITH PANCREATIC NECROSIS

To cite this article:

Lopushkov AV, Turovets MI, Popov AS, et al. . Anesthetic strategy for reducing the risk of infection in patients with pancreatic necrosis. Russian Journal of Anesthesiology and Reanimatology. 2023;(6):58‑67. (In Russ.)
https://doi.org/10.17116/anaesthesiology202306158

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BACKGROUND

Infected pancreatic necrosis and parapancreatic infection are one of the main risk factors of poor outcomes and prolonged hospital-stay in patients with pancreatic necrosis.

OBJECTIVE

To determine the effect of various anesthetic techniques in early surgical and endoscopic interventions on the risk of infection in patients with pancreatic necrosis.

MATERIAL AND METHODS

Our study included 290 patients with biliary and alcoholic-alimentary pancreatic necrosis. All patients underwent surgical interventions with various methods of anesthesia within the first week after admission. Primary end point was purulent-septic complications including sepsis. Binary logistic regression analysis was used to determine the relationship between purulent-septic complications and anesthetic technique.

RESULTS

Combined anesthesia with thoracic epidural analgesia significantly reduced the risk of infection after therapeutic and diagnostic laparoscopy from 6.9% to 0% (p=0.040) and after laparoscopic cholecystostomy from 44.4% to 16.9% (p=0.015) compared to traditional anesthesia without thoracic epidural analgesia. According to logistic regression analysis, early thoracic epidural analgesia reduced the likelihood of purulent-septic complications and sepsis by 2.2 times (p=0.011) and 12.5 times (p<0.001), respectively.

CONCLUSION

Early thoracic epidural analgesia significantly reduces the likelihood of infection in patients with pancreatic necrosis.

Keywords:

pancreatic necrosis
general anesthesia
thoracic epidural analgesia
laparoscopy
cholecystostomy
purulent-septic complication

Authors:

Lopushkov A.V.

Volgograd State Medical University

Turovets M.I.

Volgograd State Medical University

Popov A.S.

Volgograd State Medical University

Zyubina E.N.

Volgograd State Medical University

Burchuladze N.Sh.

Volgograd State Medical University

Stroganova E.P.

Volgograd State Medical University

Streltsova A.M.

Volgograd State Medical University

Kikteva O.S.

Volgograd State Medical University

Vorobyova A.A.

Volgograd Medical University

Mikhin I.V.

Volgograd State Medical University

Received:

31.05.2023

Accepted:

07.08.2023

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