Off-pump coronary artery bypass grafting in patients with obesity: combined anesthesia versus total intravenous anesthesia

Mikhail Turovets, Alexander Popov, Andrej Ekstrem, Sergey Shlakhter, Anastasia Streltsova, Yuriy Vedenin
2020 Archiv Euromedica  
researchers attribute obesity to an independent risk factor for perioperative complications of off-pump coronary artery bypass grafting (off-pump CABG). AIM. To conduct a comparative analysis of the early postoperative complications of off-pump CABG in obesity patients with with various types of anesthetic benefits. MATERIALS AND METHODS. A randomized study of the results of surgical treatment was carried out in obesity patients with coronary heart disease performing pump CABG. The study
more » ... d 197 patients. The study group (n = 98) included patients who underwent combined anesthesia (with thoracic epidural analgesia (TEA)), and patients in the control group (n = 99) underwent total intravenous anesthesia (with opioids). RESULTS. The use of combined anesthesia (with TEA) in patients with obesity significantly reduced the risk of developing new onset of renal dysfunction (p = 0.0180), respiratory complications (p = 0.0177), atrial and ventricular arrhythmias (p = 0.0029). We were less likely to diagnose other complications in patients of the study group, compared with patients in the control group: acute coronary syndrome (1.0% versus 3.0%, p = 0.3173), multiple organ failure syndrome (1.0% versus 3.0%, p = 0.3173), local infectious complications (1.0% versus 6.1%, p = 0.0561). An uncomplicated early postoperative period was observed in 89.8% of patients in the study group and in 52.5% of patients in the control group (p = 0.0000). CONCLUSION. The use of combined anesthesia (with TEA) for off-pump CABG in patients with obesity reduces the risk of early postoperative complications, duration of hospitalization and stay in an intensive care unit. K E Y w O R D S -off-pump coronary artery bypass grafting, prevention of complication, obesity, thoracic epidural analgesia.
doi:10.35630/2199-885x/2020/10/22 fatcat:snttha3d5zduhdxdr5nzzie2si