[The autonomous nervous system and blood circulation system--homeostasis and homeokinesis during spine surgery].Anesteziol Reanimatol. 2012 May-JunAR
In 30-surgical patients, operated for degenerative-dystrophic changes of the spine (microdiscectomy), with due regard for initial condition of the ANS (differentiated by Kerdo index), homeokinesis state has been studied. The circulatory system function was controlled with the use of a standard monitoring and central hemodynamics indices, that has allowed to mark out Hyper-and Hypo - eukinetic circulation types. Microdiscectomy performed under combined anesthesia (N2O/ O2 - 0.5) with fentanyl and sevorane. It was found that 68% of the surveyed patients directly before the surgery had a lack of homeokinesis (vagotonia). Comparison of the reaction of the autonomous nervous system and the circulatory system to premedication revealed that the change in the number of vagotonic patients and patients with hypokinetic type of hemodynamics had a direct linear dependence, and the number of sympathotonic patients and patients with hypokinetic type of hemodynamics -- the reverse one. Surgery, intraoperative pharmacological load, change of the body in sympathotonic patients accompanied with changes in Central hemodynamics (low afterload, eukinetic HI values), characteristic for physiological homeokinesis, which was not observed in vagotonic patients, which have remained unsuccessful (dysadaptative) hypokinetic type of blood circulation.