Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2007
[Modern inhalational anesthesia in pediatric maxillofacial surgery].
The paper deals with the use of sevoflurane and isoflurane in elective pediatric maxillofacial surgery. Having outlined the major features of anesthesia in this category of patients, the authors emphasize the application of the conception of the minimum alveolar concentration (MAC) and its derivatives (MAC bar and MAC awake) reflecting the analgesic and hypnotic power of an inhalational anesthetic, respectively, and theoretically substantiate the use of certain anesthetic concentrations at particular stages of surgery. The technique described in the paper was used in 82 patients aged 1.5 months to 18 years, undergoing cleft lip and cleft palate repair, residual lip and nose deformation repair, and other elective maxillofacial procedures. ⋯ Hemodynamics was characterized by moderate controlled hypotension with an average decrease in mean blood pressure by 30% of the age-related value. Emergence occurred 5-15 min after an anesthetic was discontinued. By and large, the technique demonstrated its efficiency and safety in this group of patients.
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Anesteziol Reanimatol · Jan 2007
Comparative Study Clinical Trial[Balanced spinal-epidural anesthesia in pediatric orthopedics].
The problem of spinal epidural anesthesia used in pediatric surgery has been inadequately studied. This investigation was undertaken to develop a balanced spinal epidural anesthesia schedule and to analyze its efficiency during orthopedic operations on the lower extremities in 119 children aged 2 to 16 years. Preference is given to sequential subarachnoidal and epidural space punctures via the same access. Comparative assessment of monitored indices during surgery and a need for postoperative analgesia in the groups of patients with conventional general anesthesia (n = 60) and those who had undergone spinal epidural anesthesia (n = 59) demonstrated a reliable intraoperative and early effective postoperative analgesia after balanced spinal epidural anesthesia.
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Anesteziol Reanimatol · Jan 2007
[Assessment of a hypnotic component on the basis of BIS monitoring during balanced anesthesia in children].
The hypnotic components of balanced anesthesia under regional anesthesia were estimated in 60 children during operations on the limbs and urogenital area. BIS monitoring was to assess the grade of sedation. ⋯ The optimal BIS index for moderate sedation was 40-60 units. Among all the types of balanced anesthesia, sevoflurane-based anesthesia was most effective.
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Anesteziol Reanimatol · Jan 2007
[Anesthesia recovery period after anesthesia with ketamine and propofol during minor surgery in children].
Forty-eight children aged 4 to 15 years, with an ASA I-II physical status, were examined. The patients underwent short mini-invasive surgical interventions under intravenous anesthesia using ketamine and propofol. ⋯ The changes in the parameters were identical in both groups. The specific features of the course of emergence from propofol-ketamine anesthesia require that the patients should be postoperatively observed.