Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2011
Clinical Trial[The use of tranexamic acid during large joint endoprosthetic surgeries].
The aim of the study is to measure the effectiveness and safety of tranexam acid during hip and knee joint endoprothesis surgeries. Tranexam (Mir-Pharm, Russia) was administered to 45 patients 30 minutes before the surgery in the dose of 10-15 mg/kg and 6 hours after first infusion in the same dose. In the control group (n = 45) Tranexam was not administered. ⋯ In both cases there were no tromboembolic or transfusional complications. The potential risk of transfusional complications was lower in the main group. Tranexam acid is an effective and safe blood loss prophylaxis measure during the large joint prosthetic surgeries.
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Anesteziol Reanimatol · May 2011
[Central venous blood oxygen saturation and venous to arterial PCO2 difference after combined heart valve surgery].
The aim of our study was to investigate the relationship between central venous oxygen saturation (ScvO2) and venous-to-arterial difference in PCO2 (Pv-aCO2) and their role in the assessment of balance between oxygen delivery and consumption after combined valve surgery. The prospective observation study included 38 adult patients with acquired valvular hear diseases, requiring surgical correction of two or more valves using cardiopulmonary bypass. All patients were divided into 2 groups according to the central value of central venous oxygen saturation (ScvO2): low ScvO2 (ScvO2 < 70%) and high ScvO2 (ScvO2 > 70%). ⋯ We observed a moderate correlation between ScvO2 and Pv-aCO2 during the early postoperative period: at the end of surgery, 6 and 12 hours after it (rho = -0.53; -0.62 and -0.43 respectively, n = 38, p < 0.01). The changes in ScvO2 and Pv-aCO2 regressed after 24 hours in ICU. Thus, decreased ScvO2 and increased Pv-aCO2 after combined valve surgery are related and reflect the rise in oxygen consumption.
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In 130 surgical patients with diseases and injuries in the area of the perineum and lower extremities the clinical effects of three modern local anesthetics: 2% solution of lidocaine, 0.5% solution of bupivacaine, 0.75% solution of ropivacaine and their combinations (2% lidocaine and 0.25% bupivacaine solution 2% lidocaine and ropivacaine 0.375% solution) were followed with regard to the influence of increasing volumes of local anesthetics and different rates of drug administration. It is established that an effective caudal anesthesia is provided with all modern local anesthetics, with increasing use of local anesthetic solution to 40 ml provides duration and the prevalence of sensory and motor blocks, the use of mixture of local anesthetics optimizes the development and maintenance of the caudal blockade.
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Anesteziol Reanimatol · May 2011
[EEG and bispectral analysis during inhalational anesthesia in children].
Bispectral index (BIS) is a parameter of the depth of anesthesia, but the use of it in children remains discussable. The study was carried out to compare EEG and BIS considering the age of patients during anesthesia with halotane, sevoflurane and consequent combination of sevoflurane and isoflurane. 60 children 3 to 17 years of age, who underwent urological surgeries, were divided into 3 groups (20 patients in each): 1st--halothane group, 2nd--sevoflurane group and 3rd--consequent combination of sevodlurane and isoflurane group. The oxygen: nitrous oxide 1:1 mixture was used in all the mentioned groups. ⋯ The BIS index was 30-39 during maintenance and 70-76 during awakening. The parameters of EEG and BIS in all the investigated groups were proportional to the clinical stage and depth of anesthesia. Based on the clinical data and its comparison to EEG and BIS values it is determined that BIS index can be used for monitoring depth of anesthesia in children.
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Anesteziol Reanimatol · May 2011
[Post-monitoring changes in zero drift of "Codman" intracranial pressure sensors].
The purpose of the study was to estimate the drift of the zero value of "Codman" intracranial pressure sensors, compared with the duration of monitoring, location of intracranial pressure sensors, and also to assess the relationship of drift to the gauge number. 60 "Codman" intracranial pressure sensors were investigated. The analysis of zero drift were made depending on the length of monitoring and location of the intracranial pressure sensor, as well as on description of the gauge number. Data are presented as median, quartiles, minimum and maximum values. ⋯ The maximum value of the drift of the zero value was 3 mm Hg. The dependence of drift on the duration of monitoring, reference values of the calibration and sensor implant site was absent. This shows the accuracy and reliability of parenchymal ICP measurement.