Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2011
Randomized Controlled Trial[Recruitment maneuver and its effect on hemodynamic in critical ill patient with acute lung injury/acute respiratory distress syndrome].
Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is a frequent complication in critical ill patients. Recruitment maneuver is rescue procedure which improve oxygenation. We confirm improving of oxygenation, decreasing of cardiac output and oxygen delivery in monocentral randomized trial.
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Anesteziol Reanimatol · Nov 2011
Randomized Controlled Trial Comparative Study[Comparison of analgesics using two devices for the patient-controlled analgesia].
The patient-controlled analgesia with two devices allows to compare analgesic agent and to regulate quantity and quality of multimodal analgesia compounds. The aim of the study is to compare efficiency of analgesic agents in method of patient controlled analgesia with two devices. ⋯ Most of patients who received morphine and placebo can determine the analgesic agent. Second group of patients choose both analgesic agent equally often. Comparative assessment of analgesics, by employing 2 PCA apparatuses in one patient, allows evaluate the efficiency of analgesics added to the conventional methods.
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Anesteziol Reanimatol · Nov 2011
Randomized Controlled Trial[Analysis of patients control analgesia with trimeperidine and ketoprofen for postoperative pain management in patients who underwent cardiac surgery].
The aim of the study is to discover adequate method of early postoperative period pain management in patients after cardiac surgery. In prospective randomized competitive study were analyzed three algorithms of analgesia: first patients controlled analgesia (PCA) with trimeperidine and (NSAID) ketoprofen, second PCA with only trimeperidine and third is ketoprofen combined with intramuscular injection of trimeperidine. There were 75 pations studied at the age of 40 to 65. ⋯ Consumption dose of trimeperidine was smaller in first group but larger than in third group where this drug was introduced fractional. All side effects were associated with trimeperedine and were depended on a dose. Patients of second group had nausea, vomiting, dizziness, weakness, enteroparesis considerably often comparing to patients of other groups, moreover rate of enteroparesis was minimal in the third group.
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Anesteziol Reanimatol · Nov 2011
Randomized Controlled Trial Comparative Study[Combined inhalation and epidural anesthesia, during aortocoronary bypass surgery on beating heart].
Aim of study is to compare efficiency and safety of different methods of combined inhalational and epidural anesthesia during aortocoronary bypass surgery on beating heart. ⋯ 40 patients suffering from coronary heart disease were included in randomized study. Two methods of combined inhalational and epidural anesthesia were compared. The first group of 22 patients were administrated extended-release epidural anesthesia with Ropivacaine 0.3% in upper thoracic region and Sevoflurane as a volatile agent. Second group of 18 patients were administrated Isoflurane and epidural anesthesia. Monitoring: (Harvard standard of monitoring), BIS, invasive monitoring of hemodynamic, the dose of anesthetic gas, internal medical audit. Result of the study showed that all patient had same duration of surgery, level of unconsciousness (BIS 40-45%) dose of valiant anesthetic agents less than 1 MAC, same dose of Ropivacaine, minimal dose of opioids, quantity and quality of intravenous infusion therapy and same amount of vasopressors. It was discovered that Sevoflurane had influenced hemodynamic less than Isoflurane. The results of internal retrospective medical study showed safety of both methods of anesthesia. Sevoflurane allowed fast postoperative recovery on 1,74 times ,early extubation in theater on 1,64 times. Both methods of combined anesthesia epidural and inhalational presented good results and can be performed in coronary bypass surgery but for fast-track surgery and anesthesia use of Sevoflurane is better.
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Anesteziol Reanimatol · Nov 2011
Randomized Controlled Trial Comparative Study[Spinal anesthesia with various anesthetic agents due to endoscopic urological procedure in patient over 60 years old].
Aim of the study is to compare efficiency and safety of method of spinal anesthesia with isobaric bypivacain (5 mg/ml) and ropivacain 5 (mg/ml) during performing transurethral resection of the prostate in patients over 60 years old. Methods 38 patients (68-82 years old ASAII-ASAIII) with hyperplasia of prostate gland were examined in randomized clinical study. Two methods of anesthetic management were compared. ⋯ Hemodynamic and condition of vegetatic homeostasis in both groups were almost equal but analyzed data presented that ropivacain (5 mg/ml) influenced hemodynamic less. Results of retrospective study demonstrates that it is safer to use isobaric ropivacain (5 ml/mg) in elderly patients for spinal anesthesia in 1.5 times p = 0,007). In conclusion spinal anesthesia with isobaric bypivacain (5mg/ml) more efficient because of duration and time of development of neuroaxial block on the other hand isobaric ropivacain 5 mg/ml is safer to use in patients older than 60 years old.