Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2013
Clinical Trial[Etiopathogenetic extracorporeal treatment of severe sepsis in patients after cardiac surgery].
The study deals with assessment of LPS-adsorption and haemodialysis with EMiC2-filters use in the complex treatment in cardio-surgery patients with heavy sepsis. 64 adult patients included in the study were divided into two groups. 26 patients of the main group with heavy sepsis (EEA > 0.6; procalcitonin level higher than 2 ng/ml) received LPS-adsorption and haemodialysis with EMiC2-filters. 38 patients of control group with heavy sepsis developed after surgeries on heart and vessels did not receive extracorporeal methods of treatment. Positive effect of combined extracorporeal treatment on haemodynamics, oxygenation, endotoxin activity decreasing, procalcitonin level, inflammatory and antiphlogistic cytokines level was identified Trend of 28-day survival increasing was indentified in the main group.
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Recent technological advances in thoracic and tracheal surgery make the anaesthesiologist use different respiratory techniques during the operation. Apneic oxygenation is a one of alternative techniques. ⋯ This article reviews publications about apneic oxygenation. The review deals with experiments on diffusion respiration in animals, physiological changes during apneic oxygenation in man and defines clinical cases when apneic oxygenation can be used.
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Anesteziol Reanimatol · Sep 2013
Randomized Controlled Trial[Intralesional administration of local anaesthetics after abdominal hysterectomy: is another technique of analgesia needed?].
The efficacy and safety of continuous wound infiltration with Ropivacaine in combination with systemic anaesthesia were assessed in randomized controlled trial in 60 patients after open hysterectomy. In the trial wound administration of Ropivacaine reduced the postoperative consumption of opioids and the intensity of pain syndrome and reduced the frequency of side effects of narcotic analgesics.
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Anesteziol Reanimatol · Sep 2013
Randomized Controlled Trial[Efficiency of hydroxyethyl starch use for arterial hypotension and shock in early postoperative period].
It is common knowledge that arterial hypotension is a one of most prevalent pathology of early neonatal period and it causes severe neurological complications. Purpose of the prospective randomized open study was to assess the efficacy of HES 130/0.4 (6% Voluven) as a start medicine for arterial hypotension in early neonatal period in comparison with normal saline solution (0.9% NaCl). ⋯ 6% Voluven is more effective than 0.9% NaCl for increasing of cardiac output, myocardial contractile ability and diuresis, normalization of liquid balance and lactate level, decreasing of cardiotonics amount. 6% Voluven can be recommended for arterial hypotension treatment in newborns with weight over 1000 gram both to normal saline solution especially in case of shock.
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Anesteziol Reanimatol · Sep 2013
Randomized Controlled Trial[Ketoprophen and nefopam combination for postoperative analgesia with minimal use of narcotic analgesics in cardio-surgical patients].
4 combinations of analgesia were studied: 1) Nefopam and patient-controlled analgesia (PCA) with Trimeperidine; 2) Ketoprofen (100 microg each 12 hours intramuscular) and PCA with Trimeperidine; 3) Nefopam, Ketoprofen and PCA with Trimeperidine; 4) PCA with Trimeperidine as monotherapy in early postoperative period in cardio-surgical patients. 80 patients (age from 40 to 70) were divided into 4 groups, 20 patients in each group. Administration of Nefopam and Ketoprofen before extubation reduced the intensity of pain syndrome (in average on 90%) and promoted the early stirring up of patients. Combination of Nefopam and Ketoprofen provided the most expressed analgesic and opioids-saving effects. ⋯ Dynamics of maximal inspiratory capacity of the lungs in the first three groups was better than in group of PCA with Trimeperidine as monotherapy beginning from 6th hour of study. In common undesirable effects was connected with Trimeperidine administration and depended on its dose. The frequency of nausea, vomit, dizziness and weakness was authentically higher in the group of PCA with Trimeperidine as monotherapy than in other groups.