Abstract
<jats:p>The purpose of the study. To study and compare the analgesic efficacy of bilateral spinal straightener blockade (ESP) with thoracic epidural analgesia (TEA) in patients after aorto-femoral bypass surgery, as well as to evaluate changes in biomarker levels to determine the optimal method of anesthesia that promotes rapid recovery and reduces the risk of perioperative complications. Materials and methods. The study was conducted from January to August 2024 at the Republican Clinical Hospital in Makhachkala. The study involved 10 male patients aged 18 to 70 years with ASA III-IV physical status. Results and discussions. The study showed a comparable level of pain relief between the two groups at rest, however, a greater number of episodes of breakthrough pain were observed in the ESP group with deep breathing. Hemodynamic parameters remained stable, however, in the TEA group there was a more significant decrease in mean blood pressure during the perioperative period. Biomarker analysis showed that the ESP group had more stable levels of ischemia markers, indicating less stress on the cardiovascular system. Conclusions. Bilateral ESP blockade provides an analgesic effect comparable to TEA in aorto-femoral bypass surgery, while providing more stable biomarker levels and MAP indicators. However, the higher frequency of breakthrough pain indicates the need to optimize technique and dosage.</jats:p>