Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2014
Case Reports[Tactics of tracheal intubation in patient with tumor of the tongue base].
Anatomic deformations can cause complications during the tracheal intubation in the maxillofacial surgery and otorhinolaryngology. The article deals with a clinical case of tracheal intubation in a patient with the anatomic deformations. Successful tracheal intubation was performed in the patient in conditions of conscious and spontaneous breathing under the local anaesthesia, when a fibreoptic bronchoscopy was not available. Furthermore the article briefly discusses techniques of the tracheal intubation in conditions of anatomic deformations of the upper airways and methods of local anaesthesia for the guttur and hypopharynx.
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Anesteziol Reanimatol · Jan 2014
[Application of shot-latency cortical somato-sensory evoked potentials for evaluation of swallowing disorders in early period after posterior fossa surgery].
Main tasks of early postoperative period in patients after posterior fossa surgery are the timely and safe weaning from mechanical ventilation and extubation. For clinical assessment of the hypopharynx function we use an algorithm developed in the intensive care unit (ICU) of the Burdenko Scientific Research Institute of Neurosurgery. Disadvantages of the clinical test for assessment of patient's readiness for extubation are subjectivity and impossibility to use it in conditions of even superficial sedation. Shot-latency somato-sensory evoked potentials (SSEP) can be applied in conditions of sedation and objectify the brain stem deficit. The goal of the study was to define the changes of cortical SSEP in patients with disorders of swallowing after posterior fossa surgery. To assess the swallowing disorders we used a scale of swallowing disorders in intubated patients with brain stem damage. We compared results of cortical SSEP, test of swallowing disorders in intubated patients and clinical results of extubation. 17 patients with tumors of posterior fossa were included in the study. All patients were divided into two groups depending on duration of mechanical ventilation. Patients of the group-1 were successfully extubated in 4.5 hours. Patients of the group-2 were mechanically ventilated more than 15 hours because of impossibility to pass the test of readiness for extubation. ⋯ Asymmetry of central conduction time and decreasing of N20 amplitude can be used as additional predictor of swallowing disorder.
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Anesteziol Reanimatol · Jan 2014
Multicenter Study[Effect of preoperative infusion volume on frequency of intraoperative nausea and vomiting as complications of spinal anaesthesia in pregnant women during caesarian operation (pilot study)].
Purpose of the study was to define a prophylactic effect of different preload volumes on the rate of intraoperative nausea and vomiting (IONV) as a complication due to spinal anaesthesia (SA) during caesarian operation (SO) in parturient. Data for analysis was collected during clinical observational multi-center research included several medical centers. ⋯ The results suppose that preload is effective method of IONV prophylactics in parturient during SO under SA if only infused preload volumes do not break specially determined limits of effective interval. If preload volume value is out of this range then preinfusion may lead to increasing risk of IONV occurrence.
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Anesteziol Reanimatol · Jan 2014
Comparative Study[Prophylaxis of intraoperative nausea, vomiting and abdominal discomfort due to spinal anaesthesia for caesarian operation].
The article deals with data of comparison of different antiemetic drugs used for prophylactics of intraoperative nausea and vomiting (IONV) during caesarian operation. 150 women included in the study were divided into three groups. Patients of the group-1 (80 women) received dproperidol 0.08-0.12 mg kg(-1) intravenously and atropine 0.006-0.009 mg kg(-1). ⋯ In the group-3 (20 women) patients received methoklopramide 0.1-0.2 mg kg(-1) intravenously. Intravenous administration of low doses of atropine and dproperidol provides the most effective prophylactics of IONV.
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Desflurane (Des)--is a modern inhalation anaesthetic available in Russia since August, 2013. Des is a halogenated ether; its chemical structure is 2-difluoromethoxy-1-1-1-2-tetrafluoroethane (C3H2F6O). Special thermocompensated evaporators are used for Des dosing. ⋯ Des has more positive qualities and fewer limitations, than other inhalation anaesthetics (halothane, isoflurane, sevoflurane). High cost of the anaesthetic is compensated by quality and controllability of anaesthesia and reduction of stay time in recovery unit. Fast elimination of the anaesthetic from a body allows reducing a frequency of complications connected with violation of upper airway and hypoxemia, promotes early discontinuation of artificial ventilation, reducing somnolence, earlier restoring a muscular tone in the postoperative period.