Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2013
Randomized Controlled Trial[Comparative assessment of prolonged femoral nerve blockade and epidural analgesia for postoperative pain in total knee joint arthroplasty].
The study deals with two mostly discussed techniques of postoperative analgesia for total knee joint arthroplasty. Surgeries were performed under subarachnoid anaesthesia with intravenous sedation. 9 patients of first group in received prolonged femoral nerve blockade as a component of multimodal analgesia. 8 patients of second group received epidural infusion of naropine. If basic technique of analgesia was not effective patients received trimeperidine 20 mg intramuscular. Patients of second group had less pain syndrome (in order to visual analogue scale) and did not need additional administration of opioids.
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Anesteziol Reanimatol · Nov 2013
Randomized Controlled Trial[Assessment of sugammadex use efficiency and safety for neuromuscular block reversion].
Blockade of neuromuscular conductivity is a considered one of basic part of a patient protection in a concept of a balanced multicomponent anesthesia. The controlled neuromuscular paralysis in a combination of a sedation, an analgesia and a hyporeflection not only provides comfortable conditions to surgeons for carrying out surgeries, but also allows to manage a gas exchange, blood circulation and a metabolism in a patient. However in clinical practice there is such complication after application of muscular relaxant (not depolarizing) as a residual curarization. ⋯ However there are number of the circumstances limiting application of preparations of this group including it is related with rather high frequency of side effects and lack of efficiency at the deep neuromuscular block. Today in an arsenal of the anesthesiologist there was the latest chemical - sugammadex. Sugammadex realizes a new approach to restoration of the neuromuscular conductivity.
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Anesteziol Reanimatol · Nov 2013
Randomized Controlled Trial[Dexmedetomidine use for postoperative adrenergic analgesia and sedation in abdominal surgery].
Comparative study of postoperative analgesia and sedation with trimeperidine and dexmedetomidine and their effects on haemodynamics and vegetative nervous system was performed. Assessment of analgesia and sedation during vagotonia (first part of the study) and hypokinetic type of haemodynamics (second part of the study) was carried out with visual analogue scale (VAS) and Richmond scale. Results of the study showed that dexmedetomidine is more effective and safer than trimeperidine for analgesia and sedation in patients with spontaneous breathing after abdominal surgery. Dexmedetomidine use allows keeping optimal type of haemodynamics and vegetative nervous system parameters on first day of postoperative period.
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Anesteziol Reanimatol · Nov 2013
Randomized Controlled Trial[Effect of early multimodal rehabilitation on postoperative recovery after abdominal hysterectomy].
Purpose of the study was to evaluate the impact of the use of enhanced recovery after surgery for the postoperative period, and the inflammatory response after hysterectomy. ⋯ In our study, the serum concentration of IL-6 and IL-1beta did not depend on the method of postoperative pain management. Using the ERAS protocol reduced postoperative plasma concentration of CRP. The increased level of CRP in the control group may be related with autoimmune reaction in wound due to delayed mobilization of patients.
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Anesteziol Reanimatol · Nov 2013
Clinical Trial[Characteristics of perioperative period in Xenon-based combined general anaesthesia in neurosurgery].
Neuroprotection could be the aim to use Xenon for general anesthesia. However the experience of Xenon anesthesia in neurosurgery is quite limited. The appraisal of Xenon based anesthesia was accomplished in 12 patients during various brain surgery. ⋯ As a resuIt there were 8 cases of arterial hypertension and 2 cases of superficial hypnotic state. Excitation (n = 3), hyperdynamic reaction (n = 8), PONV (n = 8) were detected in early postoperative period. An analysis of this study suggests a conclusion that studied method of Xenon-based anesthesia is inexpedient for neurosurgery.