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Information × Registration Number 0225U002780, (0123U101090) , R & D reports Title Optimization of the algorithm for performing regional analgesia techniques in patients with trauma in order to reduce the risks of systemic toxicity of local anesthetics and damage to nerve plexuses popup.stage_title Оптимізація алгоритму проведення регіонарних технік знеболення у пацієнтів з травмою з метою зниження ризиків системної токсичності місцевих анестетиків та пошкоджень нервових сплетень Head Bielka Kateryna Yu., Доктор медичних наук Registration Date 03-04-2025 Organization Bogomolets National Medical University popup.description1 Improving the safety of regional anesthesia of peripheral nerve plexuses by determining the optimal doses of local anesthetic and methods of performing blockades (with ultrasound control or under the control of a stimulator), which ensure sufficient block efficiency and minimally affect the function of the heart. popup.description2  It was found that the situation with regional anesthesia safety in Ukraine needs significant improvement. Only 67% of hospitals, according to the survey conducted by our department, have access to ultrasound navigation. There is also a low level of acceptance of safety measures, which include checklists, training and clinical error analyses. The results of experimental studies on domestic rabbits showed that the average time to ECG changes was 131 s ± 25.02, 95% CI [100-162] for the propofol group and 223 s ± 34.11, 95% CI [180-265] for the sevoflurane group (p = 0.001). There was no significant difference in the time to reach 75% and 50% of baseline heart rate, while the time to 25% heart rate was shorter in the propofol group (480 s ± 117, 95% CI [335-625] vs. 673 s ± 146, 95% CI [491-854], p = 0.05). The time to asystole was shorter in the propofol group (110.7 s ± 22.22 s, 95% CI [49.02-172.4] vs. 226.6 s ± 98.61 s, 95% CI [104.1-349], p = 0.047). The mean serum bupivacaine hydrochloride concentration was lower in the propofol group at the time of the first ECG changes (2.542 μg/ml ± 1.415, 95% CI [0.785 – 4.299] vs. 6.997 μg/ml ± 2.197, 95% CI [4.27 – 9.725]) in the sevoflurane group and, accordingly, at the time of reaching asystole in the propofol group the concentration was 110.7 μg/ml ± 22.22, 95% CI [49.02 – 172.4] vs. 226.6 μg/ml ± 98.61, 95% CI [104.1 – 349] in the sevoflurane group.Plasma concentration of bupivacaine at the time of rhythm disturbances and asystole, the time to the appearance of these changes was significantly higher in the sevoflurane group. However, the interval between two critical events in the sevoflurane group was shorter compared to the propofol group, which reduces the reaction time. Therefore, at this stage, the question of choosing the optimal type of general anesthesia in combination with regional blockades remains debatable. Product Description popup.authors popup.nrat_date 2025-04-03 Close