Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2001
Comparative Study[Ropivacaine (naropin), local anesthetic of choice for epidural blockade].
The purpose of this study, carried out in 132 patients with intense acute radicular pain, was search for an optimal local anesthetic to be used in combination with a steroid for therapeutic epidural blockade. Comparative analysis of analgesia attained by epidural injections of 5 ml 2% lidocaine, 4 ml 0.5% bupivacaine, and 4 ml 1% ropivacaine showed the advantages of the latter drug in stable arrest of radicular pain immediately after injection. The duration of analgesia after blockade was 1.4 +/- 0.5, 3.1 +/- 0.3, and 9.5 +/- 1.2 h, respectively. Use of ropivacaine eliminated the main shortcoming of epidural blockade in the treatment of patients with radicular pain, consisting in temporary pain relapse after discontinuation of the local anesthetic effect before development of antiinflammatory effect of the steroid.
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Anesteziol Reanimatol · Sep 2001
Comparative Study[Effects of cardiovascular therapy on risk of the development of ischemia and myocardial infarction in the postoperative period in cancer patients with ischemic heart diseases].
Analysis of 636 surgical interventions for malignant tumors in 576 chronic coronary patients showed that beta-blockers decreased the relative risk of ischemia and myocardial infarction during the postoperative period. Calcium antagonists verapamil and dihydropyridines also essentially decreased the probability of myocardial infarction and less so of myocardial ischemia. ⋯ Therapy with non-fractionated heparin involved the risk of ischemia and myocardial infarction. The causes of low cardioprotective effects of nitrates and heparin can be explained by the discontinuation syndrome, which increases the risk of exacerbation of coronary disease during the postoperative period.
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Anesteziol Reanimatol · Sep 2001
Review Comparative Study[The problem of massive blood loss in cancer surgery (analytical review)].
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Anesteziol Reanimatol · Sep 2001
Comparative Study[Hemostasis disorders in cancer patients with massive intraoperative blood loss].
The hemostasis system was examined before, during, and after surgery in 130 patients with blood loss from 50 to more than 200% total circulatory volume. Blood loss caused deep changes in the hemostasis system, presenting as acute and subacute syndrome of different hypocoagulation degree in parallel with fibrinolysis activation of different intensity, or as hemodilution coagulopathy, or combination of both. ⋯ A complex of methods for rapid diagnosis of coagulopathic hemorrhages is developed. Various approaches to the treatment of DIC syndrome during and after surgery were used in patients with massive blood loss.