СПОРЕДБА НА АНАЛГЕЗИЈА КАЈ АБДОМИНАЛНИ ОПЕРАЦИИ СО ЕПИДУРАЛ И БЕЗ ЕПИДУРАЛ
COMPARISON OF ANALGESIA IN ABDOMINAL SURGERIES WITH AND WITHOUT EPIDURAL

Summary/Abstract: Abdominal surgeries are surgeries performed in the abdomen. When talking about abdominal surgeries, great care must be taken and the diagnosis must be made accurately and promptly in order to prevent further complications. Abdominal surgeries include the following diagnoses: appendicitis, intestinal obstruction, perforated peptic ulcer, acute cholecystitis, acute pancreatitis, mesenteric thrombosis, colonic diverticulitis, volvulus, testicular torsion. The choice of anesthesia is organized by the anesthesiologist with the surgeon and depends on the patient's health condition. The patient's health condition, requirements for the surgeon, patient safety and agreement on the type of anesthesia are key factors in choosing the type of anesthesia that will be applied to the patient. In order to perform anesthesia, the following are required: qualified personnel (anesthesiologist - anesthesia technician), anesthesia machine, intubation equipment, a device for monitoring the patient's vital functions (oxygenation, ECG, ventilation, circulation, temperature), defibrillator, aspirator, gases (oxygen, nitrous oxide, compressed air, vacuum) and anesthetics (inhalation and intravenous anesthetics, relaxants, opiates, antidotes, infusion solutions, antishock drugs, etc.). The anesthesia plan and care is based on: review of documentation, medical history that the patient has, conversation with the patient (companion, parent) and physical examination of the patient, review of laboratory findings and determination of additional laboratory and functional tests to determine the patient's true condition, prescribing premedication, selection of the type of anesthesia and performance of anesthesia, determination of postoperative therapy and laboratory findings and other tests, when necessary. In patients, epidural analgesia is used in the postoperative phase, and has several advantages effective analgesia without the use of opioids (painkillers),epidural analgesia has a reduced incidence of postoperative respiratory problems and infections, a reduced incidence of postoperative myocardial infarction (heart attack), the stress on the patient's body is reduced by the surgical procedure, intestinal motility is improved due to sympathetic nervous system blockade. Nowadays, of all opioids, only remifentanil and pethidine are needed. Meperidine or pethidine is still used, but much less often than before, because it has many side effects

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