Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector156410.17816/KMJ1564Research ArticleThe use of double catheter epidural anesthesia in the lumbar segment of the spine during surgical correction of funnel chest deformitySafinR Rsafin_r.r@hotmail.comAnisimovO G-Republican Clinical Hospital, Kazan, RussiaKazan State Medical University, Kazan, Russia1508201293465465628032016Copyright © 2012, Safin R.R., Anisimov O.G.2012Aim. To provide clinically effective epidural anesthesia during corrective thoracoplasty in children with congenital deformity of the chest with the use of an access, which makes it possible to minimize the probability of accidental spinal cord injury during the procedure. Methods. Conducted was a prospective study of 40 adolescents randomized to the main group (thoracic epidural anesthesia combined with general anesthesia) and the comparison group (general anesthesia), 20 observations in each group. In order to evaluate the effectiveness of the method at the time of surgery determined was the level of cortisol and glucose, and after the operation recorded were the times of resolution of the pneumothorax and of the intensity of pain. Results. In the main group a slight decrease in the biochemical markers of stress was noted in contrast to their moderate increase by the end of the operation in the comparison group. Associated complications and pain in the postoperative period in the main group were expressed to a lesser extent than in the comparison group. Conclusion. Thoracic epidural anesthesia combined with general anesthesia may be the method of choice during surgical correction of the funnel chest deformity.Thoracic epidural anesthesiacongenital deformity of the chestthoracic plastysurgical treatmentторакальная эпидуральная анестезияврождённая деформация грудной клеткиторакальная пластикахирургическое лечение[Белопухов В.М., Анисимов О.Г., Сафин Р.Р. Экспериментальное обоснование нового способа эпидурального обезболивания и опыт его клинического использования у больных с закрытой травмой груди // Вестн. хир. им. И.И. Грекова. - 2002. - Т. 161, №6. - С. 66-69.][Гафаров Х.З., Плаксейчук Ю.А., Плаксейчук А.Ю. Лечение врождённых деформаций грудной клетки. - Казань: ФЭН, 1996. - 142 с.][Морган Д.Э., Мэгид С.М. Клиническая анестезиология: монография. - М.: БИНОМ, 2006. - 346 с.][Сафин Р.Р., Анисимов О.Г. Патент №2185199. Способ эпидуральной анестезии // Бюлл. изобр. - 2002. - №20. - С. 3.][Сафин Р.Р. Патент №2386437. Способ эпидуральной анестезии // Бюлл. изобр. - 2010. - №11. - С. 555.][Kasai T., Yaegashi K., Hirose M., Tanaka Y. Spinal cord injury in a child caused by an accidental dural puncture with a single-shot thoracic epidural needle // Anesth. Analg. - 2003. - Vol. 96. - P. 65-67.][Taenzer A.H. Inadvertent spinal anesthesia during continuous epidural anesthesia in an infant // Anesthesiology. - 2003. - Vol. 98. - P. 1014-1015.][Tsui B.C.H., Seal R., Koller J. Thoracic epidural catheter placement via the caudal approach in infants by using electrocardiographic guidance // Anesth. Analg. - 2002. - Vol. 95. - P. 326-330.][Warner D.O., Warner M.A., Ritman E.L. Atelectasis and chest wall shape during halothane anesthesia // Anesthesiology. - 1996. - Vol. 85. - P. 49-59.]