Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 1996
Comparative Study[The content of beta-endorphin, met-enkephalin and ACTH in the blood plasma during electric and drug anesthesia].
Beta-endorphin, metenkephaline, and ACTH were radioimmunoassayed in the peripheral blood plasma of 4 groups of patients subjected to microsurgery by different techniques. In 3 groups electropulsed exposure of the CNS was a component of general combined ataralgesia. In group 1 (13 patients) two Lenar devices were employed, in group 2 (5 patients) Skat-202 device, in group 3 (7 patients) Elean device. ⋯ No stable reaction of endorphin level on the electroexposure could be detected. There was no evident relationship between changes in the levels of opioid peptides and the decrease of fentanyl consumption. Besides, it is possible that the analgesic effect of electroexposure is mediated not only by the opioid, but by other mechanisms of endogenous antinociceptive system as well.
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Anesteziol Reanimatol · May 1996
Comparative Study[The risk factors for the development of the multiple organ failure syndrome in destructive pancreatitis].
The role of neutrophil leukocytes in the development of the polyorgan failure syndrome during an unfavorable course of destructive pancreatitis is discussed. The examinations of 52 patients demonstrated a high correlation of neutrophil functional activity tests (nitroblue tetrazolium reduction test and leukocyte-platelet aggregation) and disorders of microcirculation and hepatorenal involvement (detected clinically and by laboratory tests). The "critical mass" of leukocytosis has been estimated: at least 18 . 10(9)/liter, at which the risk of polyorgan failure appreciably increases. The authors discuss the advisability of selective cytopheresis in a complex of intensive care for critical states involving endogenous poisoning and leukocytosis.
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Anesteziol Reanimatol · May 1996
[The epidural administration of steroids and local anesthetics as the basis for the pathogenetic therapy of a radicular pain syndrome in the stages of its development].
The efficacy of epidural administration of a steroid drug kenalog combined with low-dose 1% lidocaine solution was assessed in 26 patients with discal hernias at various stages of the radicular pain syndrome. Registration of paired H-reflex helped define the neurophysiological criteria objectively indicating cure and normalization of the reduced activities of inhibitory structures of the spinal segmentary system as a result of therapy in patients with the radicular syndrome. The efficacy of this method ranges between 57.3 and 100% and depends on the disease duration, therefore it is preferable at the early stages of the disease (up to 4-6 months). Failure of therapy after 3 successive epidural blockings at 6-7-day intervals may be considered as an indication to surgery.