[Correction of temperature homeostasis and microcirculation under the stress-protection anesthesia in hip...

Prolonged epidural anesthesia belongs to the most effective anesthetic management schemes in total hip replacement. However, its use is related with compensatory stress-induced vasoconstriction resulting in an impaired vasoconstriction registered above the block level. It entails, in its turn, an impaired thermoregulation (hypothermia, postoperative muscle trembling), a reduced renal blood flow with diminished diuresis and metabolic lactate-acidosis. The preoperative preparation with daralgin (15 microg/kg, 3 intramuscular injections per day for 2-3 days) with its subsequent intraoperative infusion (30 microg/h) made concurrently with premedication by clofelin (1.5 microg/kg) arrest the above hemostasis impairments. Finally, the ability of stress-protection drugs to diminish the rate of postoperative fever and muscle trembling was registered.