Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2002
Clinical Trial Controlled Clinical Trial[Study of analgesic efficacy of propacetamol in the postoperative period using a double blind placebo controlled method].
The efficiency and safety of postoperative use of propacetamol was estimated in 30 patients by means of double blind placebo controlled method. The first group consisted of 15 patients to whom propacetamol was introduced intravenously in single dose of 2 g along with patient controlled anesthesia with promedol. ⋯ So it permits to consider propacetamol as basic non-opioid analgesic. In early postoperative period combination of propacetamol and opioid analgesic (promedol) reduces demands in the latter by 44%.
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Anesteziol Reanimatol · Jul 2002
[Preparations for peripheral and segmental level protection of the patient in the system of general anesthesia and postoperative analgesia].
The traditional general anesthetics and opioid seem to be insufficient for complete protection of the patient from operative trauma in major surgery. The prospective study has been done in 2 groups of patients undergoing abdominal oncological operations with multimodal general anesthesia based on midazolam, propofol, phentanyl and calipsol in microdose in preventive and postoperative analgesia by ketoprofen in the 1st group (35 cases) and the same general anesthesia in combination with prolonged epidural anesthesia with ropivacaine. Both complete anesthesia and postoperative analgesia have been achieved in each group of the patients, but in the 2nd group the doses of generally introduced analgesics with central action--phentanyl and calypsol--were threefold and twofold less, respectively, and restoration of gastric and intestinal peristalsis was more rapid (1.5 day) vs control group (3.5 days). The importance of using all the mentioned components of anesthesia and analgesia before, during and after operation to prevent the defects of antinociceptive protection and subsequent development of postoperative pain syndrome has been pointed out.
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Anesteziol Reanimatol · Jul 2002
[Use of analgesics with peripheral action in the system of complex protection of the patient from operative trauma].
Obtained for many years experience of perioperative using of analgesics with peripheral effect is summarized. The special scientific analysis was carried out in 274 patients who got different analgesics with peripheral action (aspisol, baralgin, ketoprofen, ketorolak, contrikal) at different stages of preoperative period in combination with opioid. The control group included 30 patients who got monoanalgesia by promedol after abdominal operations. ⋯ After severe traumatic abdominal or thoracal operations non-steroid anti-inflammatory drugs are used in combination with other potent analgesic with peripheral action--cortical and opioid buprenofine in minimal dose of 0.35 mg/day with good analgesic effect. To prevent the central sensitization during general anesthesia ketamine in microdose 0.5-1.0 mg/kg*hour is always used. The conclusion is made on the important role of multimodal preventive and continuous perioperative antinociceptive protection.
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Anesteziol Reanimatol · Jul 2002
Comparative Study[Choice of local anesthetic for epidural anesthesia in physiological labor].
In comparative analysis of epidural anesthesia by bupivacaine and ropivacaine the latter was shown to give smaller motor block and so can be applied at the end of both first and second stage of labor. Adequate anesthesia provides uneventful course of the second stage of labor, decreases its duration and eliminates the disorders of central hemodynamics and hormonal homeostasis. Currently naropin seems to be anesthetic of choice for epidural anesthesia of in labor by way of natural maternal passages.