EFFECTS OF LONG-TERM PNEUMOPERITONEUM ON THE FUNCTION OF EXTERNAL RESPIRATION IN THE CONDITIONS OF PROLONGED EPIDURAL ANALGESIA

The widespread in the last two and a half decades laparoscopic techniques in abdominal surgery allowing to carry out from short-scar incision not only cholecystectomy and appendectomy, but also resections of part of the colon, rectum, hemicolectomy, gastrectomy, and also pancreaticoduodenectomy are dictated by authentically smaller number of postoperative complications, volume of blood loss, pain syndrome intensity, etc. However, even short-term increase of intra-abdominal pressure is capable to have negative impact on splanchnic blood flow and pulmonary ventilation. For acceleration recovery of initial respiratory potential in the postoperative period, the pro-longed epidural anesthesia is effective; however, the role of the last at extensive laparoscopic resections according to the European recommendations are not fully defined. The purpose of the work is to assess dynamics of indicators of external respira-tion function after laparoscopic operations of large volume compared with the similar aids made of classical laparotomy access with application of the prolonged epidural analgesia. The study included 94 patients (41 men, 53 women) who according to the surgical approach are divided into two groups: 1st (n=33) are laparoscopic operations, 2nd (n=61) are laparotomy interventions. In the preoperative period and at three stages after surgery the dynamics of indicators of external respiration function and intensity of restrictive disorders was estimated. It is revealed that the long-term laparoscopic interventions executed with application of the prolonged epidural analgesia are accompanied by smaller decrease in high-speed and volume indicators of respiratory function.