Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2006
Comparative Study[Epidural block as a component of anesthesiological provision during abdominal operations].
Two modes of general anesthesia with artificial ventilation in combination with epidural block differing in a hypnotic component (inhalational or intravenous) were studied in 27 patients. A combination of general and epidural anesthesia afforded the best protection from surgical stress during major abdominal operations. ⋯ The safety and controllability of combined anesthesia increase when its individual components are monitored and the protocol is strictly observed. There is a need for further development of objective criteria for efficient regional block under general anesthesia.
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Anesteziol Reanimatol · Sep 2006
Comparative Study[Clinical experience in using isoflurane, sevoflurane, and total intravenous anesthesia during visceral transplantation].
Based on 256 anesthesias, the authors comparatively studied the results of total intravenous anesthesia (TIVA) with neuroleptic analgesics and inhalational low- and minimal flow anesthesia with isoflurane in the anesthestic support of major operations on the liver. Both sevoflurane and isoflurane may be widely used during long and traumatic operations on the liver since the agents are distinguished by a low hepatotoxicity, the absence of pharmacological activity of their metabolism, a rapid elimination from the body in a virtually unchanged form. ⋯ The minimal flow (0.4-0.5 l/min) mode uses mostly few inhalation anesthetics. The use of seroflurane reduces the period of spontaneous breathing recovery to a greater extent, activates the patient more rapidly, and substantially reduces the risk of iatrogenic complications after long and traumatic operations associated with visceral transplantation.
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Anesteziol Reanimatol · Sep 2006
Comparative Study[Comparison of two schemes of administering the Russian protamine sulfate after extracorporeal circulation in cardiosurgical patients].
The paper presents data of a study comparing two schemes (Scheme 1: a heparin/protamine ratio of 1:2; Scheme 2: a heparin/protamine ratio of 1:3) for administering protamine sulfate to neutralize heparin in patients after extracorporeal circulation. A larger dose of protamine sulfate is shown to induce significant thrombocytic dysfunction, resulting in increased postoperative hemorrhage. To minimize protamine sulfate doses required for neutralization of the anticoagulant effect of heparin is a way of preventing these complications.
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Anesteziol Reanimatol · Sep 2006
Comparative Study[Use of different types of target propofol concentration-control infusion: theoretical and practical aspects].
Examinations were made in 105 patients who had undergone total intravenous anesthesia on the basis of the immune circulating components (ICC) of propofol by different pharmacokinetic models--Marsh and Schnider, by aiming at plasma or an effector zone. Along with good controllability of ICC-anesthesia, with theoretical and practical differences of the employed models are shown. ⋯ Practical recommendations on its application are given. The prospects of anesthesia automation are briefly discussed.
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Anesteziol Reanimatol · Sep 2006
[Calculated and measured blood propofol concentrations during target-control infusion by means of a Diprifusor system during operations under extracorporeal circulation].
The study was undertaken to compare measured versus calculated propofol concentrations (C(m) and C(c), respectively), by using Diprifusor technology in cardiac surgery with cardiopulmonary bypass (CPB). The study included 10 NYHA II-III patients (aged 27-45 years) undergoing mitral valve replacement. Propofol (Diprivan PFS 50 ml, AstraZeneca) was target-control infused (TCI) by the Diprifusor system (Graseby 3500). ⋯ C(m) was 2 times higher than C(c) at all stages. A close correlation was found between C(m) and C(c): r = 0.83, p = 0.038. It is concluded that Marsh's PK/PD model predicts the trend in blood propofol concentrations during uncomplicated operations on the open heart satisfactorily, but C(c) was constantly 2 times less than C(m).