Medicina
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The article deals with the problems of perioperative management of patient with respiratory disease. The impact of general and regional anesthesia on respiratory system is discussed. Risk factors of perioperative respiratory complications are reviewed as well as general means for reducing them. Issues of anesthetic management of patients with bronchial asthma and chronic respiratory disease are discussed, putting stress on preoperative optimization of respiratory function, choice of anesthetic technique and postoperative pulmonary rehabilitation.
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Comparative Study
[Treatment of the upper cervical spine injuries with halo vest device].
In the article are described cases, when patients sustained fractures of the first and the second cervical spine vertebrae and were treated with "Halo-vest" device. We performed this investigation in order to establish efficiency of "Halo-vest" immobilization and to establish regression of neurological evaluation, patients feelings and their come back to their usual environment, when 1-2 years passed after fracture and treatment. Investigation was performed in 1999-2001. ⋯ Reposition of fractures in the upper cervical spine can be achieved with "Halo-vest" device. If close fractures repositions failed, then spondylodesis must be performed and alignment during operation can be maintained with "Halo-vest" device. After these injuries and treatment with "Halo-vest" device about 69% patients came back to their usual environment.
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Venous air embolism is the entry of air into the venous system as a consequence of trauma or iatrogenic complications (especially central venous cannulation or pressurized intravenous infusion systems). It also can occur following the surgical procedures. Venous air embolism results in right ventricular dysfunction and pulmonary injury. In this review article various causes, frequency, pathophysiology, clinical features, diagnosis, treatment, outcome and prevention of venous air embolism are discussed.
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Review Comparative Study
[Peculiarities of anesthesia for patients with valvular heart disease during non-cardiac surgery].
A careful preview history of disease and thorough physical examination of patients having valvular heart disease using modern instrumental investigation methods are important in assessing preoperative risk. Important factor in the preoperative decision process and the risk assessment is the nature of surgical procedure also. ⋯ Efforts should be joint to avoid these complications, involving both surgeon and cardiologist, anesthesiologist and general practitioner. Survey of available literature provides variable pathophysiological features of cardiac lesions, which are of paramount in importance while choosing methods of anesthesiological management during non-cardiac operations and use of anesthetics and vasoactive drugs as well for patients with aortic and mitral valve diseases.
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Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. In the case of the expanded process, still more numerous interventions are performed with general anesthesia. The objective of research is to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia caused by nitroglycerin and captopril when performing endoscopic operations of accessory nasal sinuses. ⋯ The visibility of the operative field was by one point, on the average, better than in Group H. No anesthetic complications were observed during investigation. In summary, it is possible to state that the controlled arterial hypotension caused by captopril and nitroglycerin reduced significantly intraoperative hemorrhage and improved the visibility of the operative field in endoscopic rhinosurgery.