Lidocaine as Component of Analgosition During Coronary Artery Stenting

Abstract

Minimally invasive techniques are one of the main methods for the diagnosis and treatment of coronary artery disease. Opiates are the main drugs that used for analgesia during interventional procedures, but their wide application is associated with a number of drawbacks. One of the ways to reduce the use of opiates is the concept of "multimodal anaesthesia", and one of its options is "no and low-opiate" anaesthesia. The aim of the presents study is to determine the main aspects of the lidocaine-based low and opiate-free anaesthesia during coronary artery stenting. 90 patients with coronary artery disease who underwent elective coronary artery stenting were included in the study. The patients were evenly divided into three groups, depending on the drugs used for intraoperative analgosedation. The first group (comparison) consisted of patients who received analgosedation with diazepam and fentanyl. For the non-opiate anaesthesia second group, the dosed lidocaine solution was the main component of analgesia. In order to study low-opiate analgesia based on the use of lidocaine, we formed the thirds group. Fentanyl was administered for analgesia induction, and lidocaine was administered intraoperatively to maintain the level of analgesia in combination with fentanyl infusion. For sedation, propofol was given in the target dose to achieve Level III by RAMSEY for the second and third groups. Intravenous use of lidocaine as a component of “low and no-opiate” anaesthesia is safe for coronary stenting operations. The study showed that the use of the above doses of lidocaine in comparison with traditional administration of opiates in assessing the parameters of external respiration, hemodynamics, and blood glucose and cortisol levels has a number of advantages and, at the same time, there are no negative effects typical for traditional anaesthesia. In comparison with the control group and the group of non-opiate anaesthesia, there are a smaller number of complaints of chest pain, drowsiness and numbness in the group of low-opiate anaesthesia in post-operative period.