Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2005
[Combined spinal epidural anesthesia during endoprosthetic surgeries for bone tumors in old-age children].
Thirty-five patients (ASA II-III) aged 12 to 17 years, diagnosed as having osteogenic sarcoma and Ewing's sarcoma localizing in the femur and tibia, were examined. Surgery was performed as sectoral resection of the affected bone along with knee joint endoprosthesis. Surgical intervention was made under combined spinal and epidural anesthesia (CSEA) with sedation, by using the methods for exact dosing of propofol (6-4 mg/kg x h). ⋯ The acid-alkali balance suggested the adequacy of spontaneous respiration. The only significant complication we observed was atony of the bladder that requires its catheterization till the following day. An epidural catheter makes it possible to effect adequate postoperative analgesia.
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Anesteziol Reanimatol · Jan 2005
[Optimization of antibacterial therapy in operated neonates on the basis of early diagnosis of septic complications].
The paper is based on the results obtained during examination and intensive care in 175 neonatal infants operated on for various malformations who were treated in the pediatric intensive care unit, Moscow Regional Research Institute of Clinical Studies, in 1998 to 2000. Analyzing the results has indicated that 24% of the patients have signs of early sepsis just within the first 24 postoperative hours. ⋯ The studies performed lead to the conclusion that procalcitonin is a highly sensitive and specific marker of sepsis by which postoperative septic complications can be diagnosed in the early periods. The early diagnosis of sepsis, by using the marker procalcitonin permitted timely rational correction of antibiotic therapy, which improved the basic parameters of treatment and reduced deaths from septic complications from 48 to 36%.
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Anesteziol Reanimatol · Jan 2005
[Modern approaches to the management of an anesthesiological support in pediatric ENT surgery].
The paper deals with the topical problem of pediatric anesthesiology--current approaches to performing an anesthesiological appliance in pediatric ENT surgery. The study included 1299 children aged 3 days of life to 14 with various surgical ENT abnormalities at anesthesia risk I-III (ASA) in whom surgical intervention was performed under multicomponent general anesthesia or under local anesthesia. ⋯ Since adenoid- and/or tonsillectomy, as well as tonsillotomy are the most common operations in pediatric ENT surgery, indications for and contraindications to these interventions under general anesthesia were defined. It has been shown that endonasal microendoscopic operations in children should be performed exclusively under general endotracheal anesthesia and local anesthesia is a mere one of its important constituents.