The little opioid multimodal anesthesiapotentiated by modern led irradiation of blood in red 650 nm range

Abstract

Purpose . To develop a technique for potentiating the low-opioid multimodal anesthesia with LED radiation in the red range of the spectrum at 650 ± 20 nm using autonomous optoelectronic devices. Material and methods . Portable semiconductor LED devices AFC 660 k-630/670 emitting in the red range with wavelength 650 ± 20 nm were used for contact LED exposure. 78 abdominal patients (59 women and 19 men), aged 65–87, with concomitant diseases had the multimodal anesthesia. Patients' weight ranged from 68 to 127 kg. All patients had the 3rd degree of anesthetic risk by MNOAR classification. Patients were divided into two groups: studied and control. In the studied group (n = 52), 35 patients had planned laparoscopic cholecystectomy; 17 patients had laparoscopic hernia repair. In the control group (n = 26), 19 patients had laparoscopic cholecystectomy, and 7 patients had laparoscopic hernia repair with alloplasty. A comparative study of two protective techniques against surgical aggression was made: studied group – multimodal anesthesia potentiated by contact LED exposure at the projection of large vessels with AFC bracelet (physiotherapeutic LED apparatus); control group (n = 26) – multimodal anesthesia not potentiated with contact LED exposure. Results . It has been found out that the potentiated multimodal anesthesia with portable semiconductor LED device AFC 660 k-630/670 in the red range with wavelength of 650 ± 20 nm reduced fentanyl consumption in the studied group by 3 times (in the control group fentanyl consumption was 4.76 ± 0, 39 μg/kg/h; in the studied group – 1.53 ± 0.15 μg/kg/h). Peripheral hemodynamic parameters at all stages of surgical intervention practically did not show any significant changes from the initial values. The index of central hemodynamics CI in the studied group increased at the end of the surgery from 2.53 ± 0.36 l/min m 2 to 3.61 ± 0.46 l/min m 2 . The total peripheral vascular resistance in the studied group decreased compared to the initial values from 1654.2 ± 345.1 din.c.cm –5 to 1136.7 ± 485.1 din·c·cm –5 . In the control group, CI increased comparing to the initial values from 2.79 ± 0.36 l/min m 2 to 3.14 ± 0.37 l/min m 2 . Total peripheric vascular resistance in the control group decreased from 1448.5 ± 344.5 din·c·cm –5 to 1223.9 ± 437.1 din·c·cm –5 in comparison with the initial values. Conclusion . Potentiation of multimodal anesthesia by contact LED exposure during abdominal surgery in patients of the studied group stabilized hemodynamics, increased the cardiac index and decreased total peripheral vascular resistance better than in the control group during anesthesiologic support.