Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2006
Comparative Study[Comparison of various types of epidural analgesia after abdominal operations].
The authors compare three types of epidural analgesia using a mixture of 0.125% bupivacaine solution and morphine in 102 patients after abdominal surgery. Patient-controlled analgesia was applied in Group 1; the mixture was injected as a bolus in Group 2; continuous epidural infusion was used in Group 3. The findings have indicated that patient-controlled epidural analgesia can yield an adequate analgesia with smaller doses of local anesthetics and morphine reliably and in a shorter space of time and reduce the frequency of side effects associated with the opioid.
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Anesteziol Reanimatol · Jul 2006
Comparative Study[Comparative assessment of general and regional anesthesia during total endoprosthetic operations on the knee joint].
The present paper comparatively analyzes anesthetic support in 91 patients during a total endoprosthetic operation on the knee joint. All the patients were conventionally divided into 4 groups: (1) those (n=7) in whom the operation had been made under general anesthesia (nitrous oxide, ketamine, seduxen, droperidol, and fentanyl); (2) those (n=36) who had been operated on under epidural anesthesia; (3) those (n=24) who had intraoperatively received spinal (subarachnoidal) anesthesia; (4) those (n=24) whom had been intraoperatively given combined spinal and epidural anesthesia. The study established that the above-mentioned general anesthesia failed to produce a steady-state hemodynamics; the earliest postoperative period being accompanied by a significant pain syndrome, which required the use of narcotic analgesics. ⋯ Group 3 was marked by a relative postoperative stability of parameters, but a significant pain syndrome is observed in the earliest postoperative period. The best results were obtained in Group 4 patients undeigone a combined spinal and epidural anesthesia. The component of subarachnoidal (spinal) anesthesia Marcaine Spinal provided a sufficient intraoperative analgesic effect and the component of epidural anesthesia induced virtually no pain syndrome under continuous epidural block.
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Anesteziol Reanimatol · Jul 2006
[Experience with combined spinal and epidural anesthesia at cesarean section].
The paper analyzes some experience gained in using various modes of regional anesthesia as an anesthetic appliance at cesarean sections and comparatively characterizes various types of central segmental blocks. The results of 213 cases of cesarean section performed under spinal or combined spinal and epidural anesthesia (CSEA) were generalized by the following parameters: block onset, maternal and fetal action, the quality of anesthesia and postoperative analgesia, which leads to the conclusion that CSEA is the method of choice.
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Anesteziol Reanimatol · Jul 2006
Randomized Controlled Trial Comparative Study[Multi-injection thoracic paravertebral anesthesia during breast cancer operations].
Radical and/or reconstructive operations on the breast are a common surgical procedure. Despite treatment advances, this surgical intervention is frequently associated with postoperative pain, nausea, vomiting. When used during breast cancer operations, multi-injection thoracic paravertebral anesthesia (TPVA) has the potential that is necessary for the long-term preventive treatment of pain with fewer numbers of complications. ⋯ According to the type of anesthesia, the patients were randomly divided into 2 groups with 90 persons in each: (1) those undergoing TPVA with intravenous sedation; (2) those who were given the traditional multicomponent general anesthesia. Postoperative pain was much less in the TPVA group following 1, 3, 6, and 24 hours (p < 0.01) at rest and in motion. There is evidence suggesting that it is just the procedure that may become a main alternative to the traditional general anesthesia in a clinic that has sufficient experience with regional anesthesia and appropriate equipment, with minimum complications and a qualitatively better period of recovery.