Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2007
Randomized Controlled Trial[Efficiency of preemptive intravenous paracetamol analgesia in abdominal surgery].
In a randomized, controlled study, 50 patients underwent elective surgery for abdominal cancer lesions under perioperative epidural analgesia. All the patients were randomized to receive paracetamol in a single intravenous dose of 1 g or placebo 30 minutes prior to the start of surgery. The use of 1 g of paracetamol as a single intravenous preemptive dose in abdominal surgery with perioperative epidural analgesia does not reduce the consumption of the analgesic and the intensity of pain in the postoperative period.
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The review deals with the promising method of regional anesthesia--combined epidural anesthesia. It gives indications for anesthesia, the specific features of its technical performance, and possible complications.
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Anesteziol Reanimatol · Sep 2007
Review[Sepsis and multiple organ dysfunctions--pathophysiology and the topical concepts of treatment].
Severe sepsis with multiple organ dysfunctions is still the leading cause of death in non-cardiac intensive care units (ICU). The incidence is expected to rise in the future due to the growing number of older and immunocompromized patients, the use of invasive procedures, and an increase in the percentage of aggressive or resistant microorganisms. ⋯ By taking into account pathophysiological changes, the new therapeutic concepts combine successful modulation with an improvement of the ICU management of multiple organ dysfunctions. This review discusses the actual sepsis intensive care concepts that may be useful in reducing unacceptable high mortality rates in patients with severe sepsis.
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Anesteziol Reanimatol · Sep 2007
Review[Intensive care and anesthetic maintenance in intra-abdominal hypertension].
The purpose of this review to show recent advances in the treatment of intraabdominal hypertension and abdominal compartment syndrome and to evaluate their clinical implication. To identify relevant publications, the authors have looked through the MEDLINE, EMBASE, and Cochrane Library for the original papers published since 1980. ⋯ However, laparotomy and various laparostomic techniques remain the only effective methods in treating intraabdominal hypertension in the presence of the abdominal compartment syndrome. The staf of surgical and general intensive care units should be aware of the prevention and treatment of intraabdominal hypertension and abdominal compartment syndrome.
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Anesteziol Reanimatol · Sep 2007
[Ultrasound transcranial monitoring during aortocoronary bypass surgery under extracorporeal circulation].
The paper deals with the assessment of hemodynamic parameters in the region of the circle of Willis, by using various exercise tests and transcranial Doppler study during cardiac operations under extracorporeal circulation. Some points of the timely diagnosis of air and material microembolisms are specified. There is evidence that the application of these procedures is substantiated and they may be employed in clinical practice to undertake earlier preventive measures against cervical circulatory disorders.