Abstract
<jats:p>Background. ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring urgent restoration of coronary blood flow. Urgent percutaneous coronary intervention (PCI) is associated with pronounced pain and activation of oxidative stress whose severity may depend on anesthetic regimen. Objective: to evaluate the impact of different methods of anesthetic management on pain intensity and oxidative stress markers in patients with STEMI during urgent PCI. Materials and methods. This single-center prospective study included 90 patients with STEMI who underwent urgent PCI with stenting of infarct-related coronary artery. Participants were allocated to three groups: group I received standard analgosedation; group II — multimodal low-opioid anesthesia; group III — multimodal low-opioid anesthesia combined with edaravone. Pain intensity was assessed using the Numeric Rating Scale and visual analogue scale, oxidative stress — by malondialdehyde, superoxide dismutase, and glutathione peroxidase levels at baseline and at the end of the procedure. Results. At baseline, the groups were statistically homogeneous in terms of pain intensity and oxidative stress markers. During stenting and reperfusion, pain intensity was highest in groups I, while in groups II and III it was significantly lower. By the end of the intervention, all groups demonstrated an increase in malondialdehyde level, a decrease in superoxide dismutase activity, and an increase in glutathione peroxidase. Group III showed the least pronounced changes in markers of oxidative stress. Conclusions. Anesthetic regimen affects the intensity of intraoperative pain syndrome and the severity of oxidative stress in patients with STEMI during urgent PCI. The most favorable outcomes were achieved when using multimodal low-opioid anesthesia in combination with edaravone.</jats:p>