Effects of intravenous laser radiation and long-lasting epidural blockade at reconstructive surgeries in patients with critical ischemia of lower extremities

Abstract

Purpose. To study effects of combined intravenous laser blood irradiation (ILBI) and long-lasting epidural blockade (LEB) applied pre- and postoperatively at immediate results in patients who underwent reconstructive surgery for critical ischemia of lower extremities (CILE). Materials and methods. 59 patients with arterial obliterating artherosclerosis who survived reconstructive surgery (by-pass, prosthesis) were taken into the study. 27 patients (main group) had CILE and LEB combined therapy before and after reconstructive surgery in addition to the standard therapy for 10-12 days. Controls (n-32) had the standard conservative therapy before and after the surgery. To put diagnosis and to assess the effectiveness of combined CILE and LEB therapy clinical examination, ultrasound Duplex scanning, multi-spiral CT angiography, reovasography, skin thermotherapy were performed; lipid spectrum and hemostatic indexes in blood were studied in dynamics. Lab parameters of these patients were compared to those obtained in 34 practically healthy people. Results: combined application of CILE and LEB at pre- and postoperative periods improves regional hemodynamics and microcirculation, reliably corrects biochemical and coagulologic blood indexes, reduces early postoperative complications.