[THE INFLUENCE OF ANAESTHESIA ON PERIOPERATIVE VALUES OF AMINOTERMINAL FRAGMENT OF THE BRAIN NATRIURETIC PEPTIDE PRECUSSOR IN PATIENT WITH POSTINFARCTION CARDIOSCLEROSIS UNDERGOING NONCARDIAC SURGERY].

BACKGROUND: The importance of postoperative values of cardiac damage biomarkers studying (such as troponine and NTproBNP) is stressed by recommendations of the European Society of Cardiology and the European Society of Anaesthesiologists (2014).

AIM OF THE STUDY: the effects of general and spinal anaesthesia on perioperative dynamics of NTproBNP in patients with postinfarction cardiosclerosis in the surgical treatment of benign prostatic hyperplasia.

MATERIALS AND METHODS: 67 men aged 60 to 75 years were included in a prospective, randomized study. Patients were undergone elective open surgery for prostatic hyperplasia. All patients had a history of myocardial infarction. Depending on the type of anaesthesia the patients were divided into 2 groups: The first group (35) was operated under spinal anaesthesia (SA). The second group (32) was operated under general anaesthesia (GA). The volume infusion was 2700 ± 250 ml in the first group and 1600 ± 250 ml in the second group during perioperative period. Determining the level of NTproBNP in the venous blood plasma realized four times: 1 hour before surgery, at once at the end of surgery, 12 and 24 hour after surgery.

RESULTS: The first group patients was registered an increase the values of NTproBNP in plasma 2 times from 628.6 ± 107.4 pg/mol to 1204.1 ± 141.9 pg/mol 12 hour after the operation (P < 0.01). After 24 hours the level of NTproBNP in blood plasma of the first group patients was reduced by 28%, but, however, exceeding the values in the second group is more than 1.7 times (P < 0.05).

CONCLUSION: The extra volume of the infusion during the spinal anaesthesia in the early postoperative period after the elimination of the sympathetic blockade to leads volume overload in patients with accompanying cardiac pathology.