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

Abstract

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.