Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 1999
Comparative Study[Prolonged blocking of the brachial plexus by axillary approach in children].
Surgical interventions were carried out under combined total anesthesia with prolonged blocking of the brachial plexus via axillary approach in 40 children aged 4-14 years with surgical diseases of the arms. Prolonged axillary blockade maintained adequate analgesia in the lower third of the brachial bone, ulnar joint, forearm, and hand for 24-48 h. The proposed protocols of lidocaine and bupivacaine infusion into the axillary space of the brachial plexus caused no toxic reactions in children of this age group. The method can be used in children during and after surgery.
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Anesteziol Reanimatol · Jul 1999
Comparative Study[High thoracic epidural analgesia in the postoperative period after correction of congenital heart defects in children].
The effects and side effects of thoracic epidural analgesia on the respiratory response, awakening time, and cooperation with nurses were studied. Forty children received epidural analgesia after open-heart surgery. Lidocaine was injected in a dose of 1.5-2 mg/kg every 1.5-2 h. ⋯ Cooperation with nurses was much better in this group, too. No side effects were observed in the epidural group. Therefore, thoracic epidural analgesia is a safe and effective method of postoperative analgesia for children subjected to open-heart surgery.
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Anesteziol Reanimatol · Jul 1999
Comparative Study[A comparative study of 2 methods of neuromuscular function monitoring, electromyography and acceleromyography, during anesthesia in children].
The responses of m. adductor pollici to TOF stimulation of the ulnar nerve were recorded by electromyography (EMG) and acceleromyography (AMG) in 36 children aged 2-12 years with ASA classes I-II during 36 planned surgeries. In 14 children myoplegia was attained by intravenous bolus and infusion atracurium (Tracrium) and in 22 by cisatracurium (nimbex). ⋯ EMG permits evaluating the recovery of neuromuscular conduction early after the infusion of myoplegics; complete recovery of the block is shown virtually simultaneously by AMG and EMG. EMG as a more accurate method is preferable for research, while AMG is a simpler and stable method, preferable for routine practice.
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Anesteziol Reanimatol · Jul 1999
Review Comparative Study[Pediatric regional anesthesia: rational approaches and practical aspects].
Regional anesthesia in children is to be carried out with due consideration for anatomy, physiology (specifically, neurophysiology), pharmacology of local anesthetics, and detailed knowledge of pediatric protocols of numerous regional blockades. Age-specific differences in the pharmacokinetics of local anesthetics should be borne in mind when choosing safe doses and protocols. The pharmacokinetic factors may involve the risk of toxic reactions to local anesthetics. The protocols of central neuroaxial blockades in children are characterized by certain differences, concerning the indications, anatomic reference points, choice of special equipment, doses, and schemes of administration.