Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2006
Comparative Study Clinical Trial[Induction of anesthesia with halogen-containing anesthetic agents in children].
The study has comparatively evaluated the effectiveness and safety of halothane, enflurane, and isoflurane in children during induction. Seventy hundred and eight patients aged 1-14 years who had ASA I-II anesthetic risks were examined. ⋯ The studies have established that in terms of comfort, safety, and the rate clinical effect achievement, the drugs of choice for gas induction in children are enflurane and, to a lesser extent, halothane. Gas induction with isoflurane should not be performed in children since the agent rather frequently exerts an irritant action on the upper airways, which reduces the speed of initial narcosis and increases the likelihood of one or another adverse reactions; however; it has advantages as a less hemodynamic effect.
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Forty-one children aged 4 to 15 years, who had been operated on for varicocele and hernias at various sites, were examined. Central hemodynamics, and the level of sedation and pain were assessed. Studies were performed in 2 groups of patients: 1) those who received anesthesia with ketamine in combination with propofol and 2) those who had inhalational-mask anesthesia using phtorotan in combination with nitrous oxide. They indicated that the patients more promptly emerged from phtorotan anesthesia; however, they require preventive analgesia.
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Anesteziol Reanimatol · Jan 2006
Clinical Trial[Postoperative epidural bupivacaine infusion in pediatric oncology].
The paper presents the results of use of continuous epidural bupivacaine infusion for postoperative anesthesia in 88 children operated on for malignant tumors. Two groups of patients differing in the procedure of epidural bupivacaine infusion are compared. The use of bupivacaine at a higher concentration (0.25%) within the first 12 hours of the early postoperative period can provide a more effective anesthesia than that at a concentration of 0.125%. The efficacy and tolerability of the above procedures for injecting the local anesthetic are studied and their after-effects are analyzed.
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The study deals with infusion therapies in children with thermal injury and with its impact of its qualitative composition at the local (tissue) and systemic levels. The investigations have indicated that the best qualities' in replenishing the volume of circulating blood and in eliminating hypovolemia are shown by hydroxyethylated starch (the study used voluvene) that offers advantages in the rate of correction of blood concentrations and in the maintenance of a volumic effects and that increases oxygen delivery, resulting in a rapider emergency from shock and improving the trophism of a burn wound.
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Anesteziol Reanimatol · Jan 2006
[Temperature balance and the possibility of its maintenance during general anesthesia in children].
The problems of hypothermia in the perioperative period, which are one of the most important ones in pediatric practice, in babies in particular, are solved, by using a broad spectrum of methods for preventing and correcting the patients' thermal balance. Convection heating systems exercise an on-line control over the baby's thermal regime during a surgical intervention and intensive care. The authors' own experience allows these systems to be recommended for wide practical application in the activities of anesthesiology and intensive care services.