Anesteziologiia i reanimatologiia
-
Anesteziol Reanimatol · Mar 1995
Review Comparative Study[Practical steps in the solution of the problem of patient's safety during anesthesia].
-
Anesteziol Reanimatol · Mar 1995
Comparative Study[Choice of anesthesia in geriatric patients in lower limb surgery].
Three variants of regional anesthesia were used in 162 patients operated on the lower limbs. A combination of the inguinal approach after Winnie for the blocking of the lumbar plexus and sciatic nerve provided a reliable analgesia in operations performed below the middle third of the femur. In interventions on the upper third of the femur and the hip joint segmentary conduction blocking (epidural or spinal anesthesia) should be preferred in geriatric patients, because it is impossible to block the branches of the obturator, sciatic, upper and lower gluteal nerves innervating the hip joint by Winnie's technique, an anatomical obstacle (fascial node) preventing the procedure, as was shown by anatomical experiments with 28 corpses.
-
Anesteziol Reanimatol · Mar 1995
Review Comparative Study[Possibilities and prospects of regional anesthesia in the current anesthesiological practice].
Presents a modern concept of conduction blocking, permitting revision of indication for it. Blocking is regarded as the basic component of present-day anesthesiologic care responsible for analgesia and regional muscle relaxation. Use of objective methods of verification of the elements of nervous formations improves the efficacy of and extends the range of indications for regional blocking solves the problem of regulation, and rational combination of this modality with selectively acting drugs provides the optimal realization of balanced anesthesia.
-
Anesteziol Reanimatol · Mar 1995
Comparative Study[Myocardial protection from ischemic and reperfusion injuries in reconstructive heart surgery].
Methods of myocardial protection from ischemic and reperfusion injuries in various operations on the open heart were compared. The study demonstrated the advantages of combined antegrade-retrograde delivery of cardioplegic solution during ischemia in aortocoronary shunting and correction of valvular defects. The method of myocardial protection from reperfusion injury by perfusing the heart with blood solution of a special composition before removing the clamp from the aorta (controlled reperfusion) proved to be effective, which was confirmed by clinical and biochemical data presented in this paper. Hence, our findings confirmed that the optimal protection of the myocardium can be attained by combined cold crystalloid cardioplegia together with controlled reperfusion of the myocardium.
-
Anesteziol Reanimatol · Mar 1995
Comparative Study[Adequacy of amputation analgesia as a factor preventing the triggering of pain memory in the genesis of phantom pain syndrome].
Examinations of 72 patients with a history of amputation of the lower limb showed that preamputation pain may be transformed into phantom pain via "pain memory" mechanisms. This fact is confirmed by similarity of the verbal structure of preamputation pain and phantom pain syndrome, which are particularly expressed in the patients operated on under total anesthesia. ⋯ Prolonged epidural anesthesia provides a pain-free period before surgery by disrupting the time relationship between nociceptive impulsation entry in the CNS structures and amputation, thus preventing fixation of 'pain experience' survived in the memory. The adequacy of intraoperative analgesia attained by prolonged epidural anesthesia plays the crucial role in prevention of realization of the "pain memory" effect.