Spinal analgesia increases the frequency of noradrenalin administration, but does not affect the oxygen status of patients during laparoscopic surgeries for colorectal cancer

The objective. To assess the effect of spinal analgesia on the oxygen status and the level of myocardial damage markers in patients with colorectal cancer operated by laparoscopic access.

Subjects and methods. 60 patients with colorectal cancer operated under general anesthesia with laparoscopic access were divided into two groups. In group 1 (n=30) intraoperative analgesia was performed with fentanyl. In Group 2 (n=30) before the induction of general anesthesia was performed an intrathecal administration of 10.0-12.5 mg of bupivacaine and 200 mcg of morphine. In case of decreasing an MAP <65 mm Hg.V. a continue infusion of noradrenaline was began. The frequency of administration and the average dose of noradrenalin were estimated, as well as the levels of lactate, pH, BE, ScvO2, highly specific cardiac troponin I (hs-cTnI ) and NT-proBNP in the central venous blood.

Results. The frequency of noradrenalin administration in group 2 was significantly higher compared to group 1 – 56.7% versus 26.7% (HR=2.1; 95% CI 0.86-4.16; p=0.036). Noradrenalin dose, the levels of lactate, pH, BE, ScvO2, hs-cTnI and NT-proBNP levels did not differ significantly in both groups at all stages of research.

Conclusion. Spinal analgesia increases the frequency of noradrenalin administration but does not affect the oxygen status and the level of myocardial damage markers in patients with colorectal cancer operated by laparoscopic access.