Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2002
Comparative Study[Carboxyperitoneum and clinical efficacy of nondepolarizing relaxants with different types of metabolism].
A total of 108 patients operated on the abdominal cavity were examined with laparoscopic equipment or via laparotomic assess. The recovery time of neuromuscular conduction was defined for a myorelaxant with organ-depended metabolism (pipecuronium) and, predominantly, nonorgan-depended metabolism (athracurium and cisathracurium) in relation to the type of surgical technique (laparoscopy and laparotomy). It is concluded that carboxyperitoneum prolongs the recovery of neuromuscular conduction for pipecuronium without affecting this parameter in athracurium and cisathracurium. It is more expedient to use these myorelaxants during laparoscopic operations than pipecuronium, a myorelaxant having organ-dependent metabolism.
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Anesteziol Reanimatol · Sep 2002
Comparative Study[Optimization of anesthesiological maintenance of x-ray surgical interventions in children].
Two procedures for intravenous anesthesia during X-ray surgical interventions were evaluated in 38 children aged 3 to 13 years. Initial anesthesia (with intramuscular midazole and ketamine), followed by the fractional use of the latter agents in Group 1 and propofol in Group 2, in order to maintain anesthesia. Blood pressure (BP) (noninvasively), heart rate (HR), SpO2, and respiratory rate (RR) were monitored. ⋯ In Group these changes retained throughout the basic stage of intervention. In Group 2 on propofol infusion, BPmean and HR returned to normal values and remained at this level till the end of the intervention, SpO2 and RR did not differ from the baseline values in both groups. Thus, a combination of intravenous ketamine and intramuscular propofol provides steady-state values of BP and HR at the basic state of X-ray surgical intervention in children, which increases the reliability of studies and surgical safety in patients.
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Clinical and electrophysiological studies were performed in 10 volunteers and 45 patients with Classes I and II, as stated by the American Society of Anesthesiologists, to evaluate consciousness during sedation. Prior studies on volunteers showed that there was a clear correlation between N-REM sleep and SEF in 90% of cases. Based on these findings, the authors propose a modified suppressed consciousness scale whose rating was adjusted to the levels of N-REM sleep. Irrespective of the type and technique of sedation (infusion of thiopental and propofol; PCS, midazolam), changes in the levels of drug-depressed consciousness were found to be the same.
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Anesteziol Reanimatol · Sep 2002
[Prevention of postoperative nausea and vomiting with highly selective 5-HT3 serotonin receptors antagonists during different types of surgery].
A prospective study was conducted to examine the efficacy of highly selective, 5-HT3 serotonin receptor antagonists (Zofran, 4 mg; Latran, 4 and 8 mg; Navoban, 2 and 5 mg) during plastic and abdominal (endoscopic and routine) interventions in 165 patients aged 14 to 77 years who had ASA Classes I-III. The drugs caused no adverse reactions and were effective in controlling postoperative nausea and vomiting (PONV) after surgery under total intravenous anesthesia. ⋯ Risk factors for PONV are analyzed. The pathophysiological aspects of PONV and practical approaches to making an antiemetic strategy are discussed.
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Anesteziol Reanimatol · Sep 2002
[Implementation of modern principles of blood saving methods at cardiac surgery under extracorporeal circulation].
The introduction of principles of bloodless surgery into different areas of practical medicine is favoured by not only risks from donor blood transfusion, but also by the results of the researches dealing with the body's adaptation to acute anemia, with the determination of its allowable limits, and with much experience with bloodless operations used in Jehovah's Witnesses. The present study was undertaken to make a scientific-and-practical assessment of actual own blood funds and their introduction in order to decrease or refuse to use donor blood at cardiac surgery under extracorporeal circulation (EC). ⋯ The introduction of the above own blood saving methods may decrease the use of donor erythrocytes and freshly frozen plasma by 2.6 and 1.8 times, respectively, may completely refuse transfusing thromboplasma, assure adequate hemostasis, reduce the incidence of adverse reactions associated with donor blood transfusion in cardiac surgical patients. A complex use of the developed saving donor blood methods and pharmaceuticals aimed at improving hemostasis allowed donor blood transfusion to be completely refused in more than 70% of patients at aortocoronary bypass surgery under EC.