Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 1998
Comparative Study[High epidural anesthesia in the correction of congenital heart defects with artificial circulation in children].
Effects of high thoracic epidural anesthesia (TEA) on hemodynamics were studied in patients undergoing cardiopulmonary bypass (CPB) surgery. In 7 patients aged 3-7 years, TEA was used as an adjunct to standard oxygen-air-isoflurane anesthesia. ⋯ Usually we take a loading dose of 4.5 mg/kg of lidocaine and 1 microgram/kg of fentanyl, which is followed after 40-50 min by 3.5 mg/kg lidocaine and 1 microgram/kg fentanyl. TEA ensures good pain relief and hemodynamic stability and can be accepted as a safe and effective anesthetic technique in combination with inhalation anesthesia in children subjected to CPB.
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Anesteziol Reanimatol · Jan 1998
[Regional anesthesias in children--the concept, advantages and general principles].
Validates the concept and discusses the advantages of central and peripheral regional anesthesias in children in combination with superficial narcosis during the stage of analgesia in surgical interventions of any severity. Emphasizes the efficacy of regional blocking, including prolonged ones, for postoperative analgesia. Presents the fundamentals of regional anesthesias in children.
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Anesteziol Reanimatol · Jan 1998
[Caudal epidural anesthesia in children operated on in the area of the lumbosacral segments].
Analgesia of children operated on the lumbosacral segments is discussed. Balanced total anesthesia was used with caudal epidural blocking by a combination of alpha 2-agonist clofelin, local amide anesthetic bupivacaine, and narcotic analgesic promedol. Injection of a combination of clofelin (0.01% solution) in a dose of 1 microgram/kg, standard dose of 0.25% bupivacaine solution with adrenaline (1:200,000) in a dose of 0.3 ml/kg, and promedol in a dose of 0.2 mg/kg into the epidural space via the caudal approach in the presence of superficial anesthesia with halothane (0.2-0.4 vol/%), nitrogen oxide and oxygen in 2:1 ratio ensured adequate analgesia and effective neurovegetative protection both during the operation and the first 25 h after it.
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Anesteziol Reanimatol · Jan 1998
[New potentials for monitoring the temperature and the relative and absolute humidity of the air-oxygen mixture during the prolonged artificial ventilation of newborn infants].
A new HTM-902 monitor (UCCP, Germany/Serviceinstrument, Russia) was used for continuous measurements of the temperature and relative and absolute humidity of inspired gas during prolonged mechanical ventilation in 86 neonates with respiratory failure caused by the respiratory distress syndrome (n = 42), meconium aspiration syndrome (n = 28), and congenital pneumonia (n = 16). All measurements were performed with a special probe connected to the inspiratory contour through a standard adapter close to the patient's T-piece. ⋯ For maintaining adequate humidity of inspired gas after any changes in the ventilator flow rate or in the temperature inside the incubator, the heating power of the humidifier had to be corrected. However, even with servocontrolled humidifiers and humidity regulation, an increase of temperature inside the incubator over 35 degrees C made impossible the maintenance of the inspired gas humidity at the level of 96-100% with its temperature at the level of the patient's T-piece no higher than 37 degrees C.