Multimodal low-opioid anesthesia - a new approach to the issue of adequate intraoperative analgesia.

The paper is devoted to the study of the effectiveness of multimodal low-opioid anesthesia during coronary bypass grafting (CABG) surgery under artificial blood circulation. The study included 36 patients aged 69,5±6.2 years, who were performed CABG. All patients were operated under general anesthesia. The average duration of anesthesia was 257,4±19,1 min. Induction included propofol (1,52±0.05 mg/kg), fentanyl (1-1.5 μg/kg), pipecuronium bromide (0.1 mg/kg). Maintenance of Maintaining anesthesia: Sevoflurane (1.5-2MAC). Аnesthesia: ketamine (0.5 mg/kg), lidocaine 1 mg/kg bolus, with the establishment of continuous infusion (1.5-2 mg/kg/h). The average dose of fentanyl, which was used for the entire period of anesthesiology support was 1,09±0.03 μg/kg/h (358,3±27,1 μg for the duration of surgery). As a result of the carried-out researches it was established, that multimodal low-opioid anesthesia, provides an adequate analgesic effect, and allows to refuse from intraoperative application of high doses of narcotic analgesics in the performance of highly traumatic operations, which is confirmed by the lack of hemodynamic and endocrine-metabolic shifts in its use.