Coronary arteries disease and its complications are the most frequent causes of death among people all over the world. Spasm and thrombosis of the coronary arteries are the main pathogeous causes of severe complications. The present review is devoted to the actual problem of increasing the effectiveness of conservative treatment of patients with ischemic heart disease by means of various methods of anesthesia. Modern concepts of the pathophysiology of coronary arteries disease, in particular, mechanism of pain, presented in the current views on the state of analgesia in cardiology, are described. The authors made analysis available today drugs used in the treatment of acute coronary syndrome and myocardial infarction. The action mechanisms of drugs from the point of view of clinical pathophysiology are presented. The authors identified advantages and side-effects of several drugs groups. The possibilities of using thoracic epidural anesthesia for care coronary heart disease, the mechanism of action of epidural anesthesia, clinical features, its anti-ischemic effect on the myocardium, the effect on the hemodynamics are described in details. Possible side effects and complications that the doctors encountered in medical practice and ways of their correction are described. In conclusion, the authors emphasize the perspective of wide practical use of epidural analgesia using local anesthetics and narcotic analgesics in cardiac patients.
unstable angina pectoris, epidural anesthesia.
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