Anesthetic support reducing surgical stress response in redo hip replacement for periprosthetic infection

Kazanin A.A.; Zagrekov V.I.; Lebedev M.Yu.; Nargizyan A.Z.; Mitrofanov V.N.

doi:https://doi.org/10.17116/anaesthesiology202601136

Kazanin A.A.

Privolzhsky Research Medical University

ORCID: 0000-0001-8049-4546

Zagrekov V.I.

Privolzhsky Research Medical University

Lebedev M.Yu.

Privolzhsky Research Medical University

Nargizyan A.Z.

Privolzhsky Research Medical University

ORCID: 0000-0001-8449-878X

Mitrofanov V.N.

Privolzhsky Research Medical University

ORCID: 0000-0003-2046-3865

Anesthetic support reducing surgical stress response in redo hip replacement for periprosthetic infection

Authors:

Kazanin A.A., Zagrekov V.I., Lebedev M.Yu., Nargizyan A.Z., Mitrofanov V.N.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2026;(1): 36‑41

DOI: 10.17116/anaesthesiology202601136

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To cite this article:

Kazanin AA, Zagrekov VI, Lebedev MYu, Nargizyan AZ, Mitrofanov VN. Anesthetic support reducing surgical stress response in redo hip replacement for periprosthetic infection. Russian Journal of Anesthesiology and Reanimatology. 2026;(1):36‑41. (In Russ.)
https://doi.org/10.17116/anaesthesiology202601136

Использование инфографики авторами научных работ

OBJECTIVE

To evaluate the effect of combined spinal-epidural anesthesia and additional immune enteral nutrition on pain syndrome and surgical stress response in redo hip replacement for periprosthetic infection.

MATERIAL AND METHODS

An open prospective randomized simple blind trial included 100 patients who underwent redo hip replacement for periprosthetic infection: group 1 (n=28) — general anesthesia with sevoflurane, no additional nutrition; group 2 (n=36) — combined spinal-epidural anesthesia, no additional nutrition; group 3 (n=36) — combined spinal-epidural anesthesia with additional enteral nutrition (500 ml) 3 days before surgery for 10 days. VAS scores of pain syndrome were assessed in 1, 3, 5 and 7 days after surgery. In all groups, serum cortisol was assessed before anesthesia, after removal of all components of prosthesis, in the morning on the 1^st, 3^rd, 5^th and 7^th days after surgery.

RESULTS

There was significantly more severe pain in group 1 compared to groups 2 and 3. Serum cortisol was lower in groups 2 and 3 during surgery (p=0.001), 1 (p=0.028), 3 (p=0.001) and 5 (p=0.016) day after surgery. In group 3, serum cortisol was lower in 3 (p=0.001) days after surgery.

CONCLUSION

Combined spinal-epidural anesthesia and immune enteral nutrition in redo hip replacement for periprosthetic infection reduce endocrine and metabolic components of surgical stress response. Epidural analgesia in postoperative period contributes to less severe pain and lower cortisol concentrations during and after epidural anesthesia.

Keywords:

spinal epidural anesthesia

general anesthesia

periprosthetic infection

enteral nutrition

cortisol

stress response

Authors:

Kazanin A.A.

Privolzhsky Research Medical University

ORCID: 0000-0001-8049-4546

Zagrekov V.I.

Privolzhsky Research Medical University

Lebedev M.Yu.

Privolzhsky Research Medical University

Nargizyan A.Z.

Privolzhsky Research Medical University

ORCID: 0000-0001-8449-878X

Mitrofanov V.N.

Privolzhsky Research Medical University

ORCID: 0000-0003-2046-3865

Received:

15.10.2024

Accepted:

05.08.2025

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References:

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