Anesteziologiia i reanimatologiia
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The article is a literature review on awake craniotomy. History of method, indications and contraindications, necessary conditions for successful application as well as complications and their prevention and correction are considered Outcomes in patients with neuro-oncological pathology and in patients with intractable epilepsy after awake craniotomy are also analyzed. It's also shown that awake craniotomy can make removal of tumors near eloquent cortex more radical and improve neurological outcome in such patients.
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Anesteziol Reanimatol · Jul 2012
[Intensive therapy in patients with severe traumatic brain injury complicated by delirium].
Delirium can greatly complicate progressing of TBI. Early diagnosis and intensive therapy optimization can improve the outcome. Retrospective-prospective study was performed in patients with severe TBI and delirium. 27 patients (mean age--40.8 +/- 3.3 years) were involved in experimental group and 25 patients (mean age 49.0 +/- 4.5 years)--in control group. ⋯ Reamberin ("Polisan", Russia) infusion (800 ml/day for 7 days after injury) was included in the therapy plan for the experimental group. Modified RASS score was equal in both groups on the first day (1.67 +/- 0.37 in experimental and 1.88 +/- 0.28 in control group), but later RASS score was lower in experimental group (0.7 +/- 0.30 and 1.41 +/- 0.26 (p = 0.042) on the third day; 0.45 +/- 0.20 and 1.09 +/- 0.36 (p = 0.012) on the 5th day; 0.2. +/- 0.14 and 1.00 +/- 0.39 (p = 0.008) on the 7th day). The correlation of the modified Richmond Agitation Sedation Scale (RASS) score with the ISS score and with the length of stay in ICU was noted Reamberin improves mental status in patients with severe TBI complicated by delirium, especially, with alcohol intoxication.
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The review describes postoperative disorders of the cognitive functions' (memory attention, speech, abstract thinking etc.) which is known as POCD. Frequency of POCD depending on pathology and age of patients, type of surgery and anesthesia is considered. Risk factors of POCD, especially advanced age and initial cognitive disorders are also noted. Modern diagnostic, treatment and prophylaxis facilities are discussed.
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Anesteziol Reanimatol · Jul 2012
Comparative Study[Residual neuromuscular blockade after muscle relaxants administration in neurosurgical patients].
The paper analyzes the incidence of residual neuromuscular blockade (NMB) after pipecuronium and rocuronium administration in 124 neurosurgical patients. We analyzed neuromuscular conductance with TOF-Watch SX Residual NMB incidence after neuromuscular blocking agents administration in neurosurgical patients is 87.7%. Use of pipecuronium accompanied by a greater incidence and duration of residual NMB in comparison with rocuronium. Sugammadex administration is effective method of residual NMB reversal and can restore NMC in 3-5 minutes.