Aim. The evaluate the possibility of predicting critical incidents development during elective surgery using Duke University activities of daily living questionnaire, a six-minute walk test, cardiopulmonary exercise testing.Methods. 36 patients who had undergone elective abdominal surgery were included in the study. To determine the functional state in preoperative period patients filled in Duke University activities of daily living questionnaire, performed a 6-minute walk test, cardiopulmonary exercise testing. Critical incidents analysis was conducted by E.A. Kazakova method (2005) at two stages: induction and maintenance of anesthesia. Using statistical methods the most informative indicators for predicting critical incidents were determined.Results. Logistic regression analysis demonstrated that only the anaerobic threshold and 6-minute walk test significantly contributed to predicting critical incidents. At the same time, ROC-analysis demonstrated the predictive value of using only the anaerobic threshold to determine the likelihood of critical incidents. It was found that this indicator threshold value is 10.85 ml/kg per minute with 100% sensitivity and 95% specificity. It is also proved that the patients’ subjective assessment leads to an overestimation of their functional state.Conclusion. Anaerobic threshold indicator determined by a cardiopulmonary exercise testing can be used as a criterion for predicting critical incidents development; reduction in the anaerobic threshold of less than 10.85 mL/kg per minute indicates the likelihood of critical incidents development with a high level of sensitivity and specificity.

Summary. The aim of the study was to compare hemodynamic changes when using ropivacaine and levobupivacaine in patients during spinal anesthesia. Materials and methods: The study included 48 patients who were randomized into two groups, depending on the anesthetic used: group P ropivacaine, group L levobupivacaine. Changes in mean arterial pressure and heart rate were evaluated. Results: patients in group L showed stable hemodynamic parameters. On the contrary, in the group P for 12 min, arterial hypotension was registered in 45.8% of the subjects, for 15 min it was detected in 37.5% of cases. At 18 min, a decrease in mean arterial pressure was observed in 41.6% of patients, while in 12.5% of cases it was necessary to connect vasopressor support for norepinephrine in a dosage of 0.070.15 g/kg/min. When analyzing the heart rate of less than 60 beats/min in group L was not identified. At the same time, in group P, sinus bradycardia was registered at all stages of control of the heart rate, and in some cases atropine correction was required. Conclusions: the course of anesthesia in the group using levobupivacaine was characterized by stable mean arterial pressure and heart rate. Patients in the ropivacaine group showed a decrease in mean arterial pressure of less than 70 mm Hg. in a controlled period of time from 12.5% to 48.5% for the purpose of correction of which, use of vasopressor support was required by 12.5%. Bradycardia in this group was registered in 12.5% -54.1% of cases, while atropine was used in 12.5%.