Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Comparative evaluation of the safety and efficacy of xenon anesthesia in elderly patients with spinal neurosurgical interventions

Authors: A.V. Solenkova, A.Yu. Lubnin, N.A. Konovalov, A.S. Kulikov, O.N. Ivanova, K.A. Kozlova, M.A. Martynova, E.S. Brinyuk

Company:
N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, 125047, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2020-17-1-32-43

UDC: 616.8

Link: Clinical Physiology of Blood Circulaiton. 2020; 17 (1): 32-43

Quote as: Solenkova A.V., Lubnin A.Yu., Konovalov N.A., Kulikov A.S., Ivanova O.N., Kozlova K.A., Martynova M.A., Brinyuk E.S. Comparative evaluation of the safety and efficacy of xenon anesthesia in elderly patients with spinal neurosurgical interventions. Clinical Physiology of Circulation. 2020; 17 (1): 32–43 (in Russ.). DOI: 10.24022/1814-6910-202017-1-32-43

Received / Accepted:  11.10.2019/21.11.2019

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Abstract

Objective. Assess the safety and efficacy of xenon anesthesia compared with total intravenous anesthesia (TIVA) with propofol in elderly patients during spinal neurosurgical operations.

Material and methods. A prospective randomized study included 60 patients (mean age 74.6±11.2 years) who underwent spinal surgery. Inclusion criteria: patients with ASA III–IV with comorbid and cardiovascular pathology. All patients before surgery MET score < 4. Predictive risk assessment of cardiac and general complications was performed in all patients before surgery. In 1st group (n=30) patients were operated with xenon anesthesia, in 2nd group (n=30) patients were operated with TIVA propofol. Fentanyl was used as an analgesic in both groups. The haemodynamics, acid-base status and arterial blood gases, bispectral monitoring of anesthesia, recovery effects, side effects and complications were compared.

Results. The results of the study showed that xenon anesthesia meets the high safety requirements of elderly patients. Hemodynamic profile with xenon anesthesia is preferable to TIVA propofol. In the 1st group, there were no episodes of intraoperative hypotension and arrhythmia, in contrast to the 2nd group where inotropic drugs and vasopressors (dopamine/noradrenaline) were used to correct hypotension in 12 patients. When using xenon anesthesia in elderly patients, the BIS index values show accordance with the clinical signs of anesthesia. The BIS-index values were identical to the recommended profile in both study groups. All patients in the 1st group were extubated in the operating room (average extubation time 3,8±0,4 min) and transferred to wake-up room. In the 2nd group, patients were extubated in the operating room/wake-up room (average extubation time 6,9±0,4 min).

Conclusion. Xenon anesthesia is an effective and safe for elderly patients during spinal neurosurgical operations. The advantages of xenon anesthesia are hemodynamic stability and good recovery effects of anesthesia. Xenon anesthesia is preferable for patients with comorbid cardiovascular pathology.

About Authors

  • Alla V. Solenkova, Cand. Med. Sc., Anesthesiologist; orcid.org/0000-0001-7081-2950
  • Andrey Yu. Lubnin, Dr. Med. Sc., Professor, Head of Department of Anesthesiology and Intensive Care; orcid.org/0000-0003-2595-5877
  • Nikolay A. Konovalov, Dr. Med. Sc., Professor, Corresponding Member of RAS, Head of Department of Spinal Surgery; orcid.org/0000-0002-9976-948X
  • Aleksandr S. Kulikov, Cand. Med. Sc., Senior Researcher; orcid.org/0000-0002-2852-6544
  • Ol’ga N. Ivanova, Anesthesiologist; orcid.org/0000-0003-1253-8337
  • Kseniya A. Kozlova, Anesthesiologist; orcid.org/0000-0002-7142-229X
  • Mariya A. Martynova, Cand. Med. Sc., Neurosurgeon; orcid.org/0000-0002-1727-5102
  • Evgeniy S. Brinyuk, Postgraduate; orcid.org/0000-0001-6184-7481


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