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Часто включает использование как регионарной, так и общей анестезии [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). \n\n**Преимущества комбинированной анестезии**: \n- уменьшение общей дозы анестетиков [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/); \n- снижение риска осложнений [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/); \n- возможность управлять обезболиванием и психологическим состоянием пациента [4](https://obrezaniepro.ru/circumcision/anesthesia/). \n\n## Виды\nНекоторые виды комбинированной анестезии: \n* **Сочетание местной и общей анестезии** [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/)[3](https://sabina.clinic/paczientam/anesteziya/). Например, анестетик вводят в определённую область тела (местная анестезия) и одновременно используют препараты для общей анестезии (пропофол, севофлуран и др.) [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). Комбинация позволяет уменьшить дозу каждого анестетика, снижая риск побочных эффектов [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). \n* **Сочетание эпидуральной и спинальной анестезии** [15](https://pmedica.ru/services/anesteziologiya/111962). Предварительно обезболивают выбранный участок кожи, раствор для спинальной анестезии вводят на уровне 3 и 4 поясничных позвонков в субарахноидальное пространство, при эпидуральной анестезии — в эпидуральное пространство позвоночного канала [15](https://pmedica.ru/services/anesteziologiya/111962). \n\n## Показания\nКомбинированная анестезия применяется в ситуациях, требующих длительных и сложных хирургических вмешательств, где необходимо обеспечить глубокое и продолжительное обезболивание [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). К таким ситуациям относятся крупные абдоминальные и ортопедические операции, а также роды, требующие обезболивания [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). \n\n## Противопоказания\nНекоторые противопоказания к применению комбинированной анестезии: \n* аллергические реакции на используемые анестетики [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/); \n* инфекционные процессы в области введения анестетиков [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/); \n* тяжёлые кардиопульмональные заболевания и другие состояния, которые могут увеличить риск осложнений [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). \n\nРешение о применении комбинированной анестезии принимается индивидуально с учётом состояния здоровья пациента и особенностей предстоящей операции [1](https://romfarma.ru/blog/spetsializirovannye-stati/chto-takoe-kombinirovannaya-anesteziya-i-kakie-nuzhny-meditsinskie-raskhodnye-materialy/). \n\n## Осложнения\nПри проведении комбинированной анестезии осложнения встречаются редко, преимущественно в первые 15 минут наркоза (период индукции), во время пробуждения больного и в посленаркозном периоде [18](https://www.georgtech.ru/wp-content/uploads/2012/07/%D0%9B%D0%B5%D0%BA%D1%86%D0%B8%D1%8F-%E2%84%965-%D0%9E%D1%81%D0%BD%D0%BE%D0%B2%D1%8B-%D0%B0%D0%BD%D0%B5%D1%81%D1%82%D0%B5%D0%B7%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D0%B8.-%D0%9C%D0%B5%D1%81%D1%82%D0%BD%D0%B0%D1%8F-%D0%B8-%D0%BE%D0%B1%D1%89%D0%B0%D1%8F-%D0%B0%D0%BD%D0%B5%D1%81%D1%82%D0%B5%D0%B7%D0%B8%D1%8F.pdf). Некоторые возможные осложнения: \n* **Передозировка и аллергическая реакция** — если подбор компонентов проводился без учёта особенностей организма пациента [17](https://msk.gm-med.ru/vracham/anesteziologiya/xarakteristika-oslozhnenij-anestezii-vidyi-i-prichinyi.html). \n* **Судорожная активность** — наркотические препараты, потенцируя действие друг друга, могут вызвать судорожную активность [8](https://primacad.ru/sveden/files/36.05.01_Anesteziologiya_uch.posob.pdf). 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