Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2006
Review[Perioperative management of patients during general endoprosthethic operations on the knee joint (a review of literature)].
Arthrosis deformans of the knee joint (gonarthrosis) is a common disease accompanied by pain syndrome and disability. Medical treatment of the disease ensures only a temporary analgesic effect and fails to restore the range of motion in the legs. General endoprosthetic operations on the knee joint can significantly improve the results of treatment, alleviate pain, and restore the patients' working capacity. ⋯ Different approaches to adequate anesthesia are considered in both intra- and postoperative period. Numerous references lead to the conclusion that many widely used anesthetic procedures (general inhalational and intravenous anesthesia, high-conduction anesthesia, etc.) are incompletely adequate during a general endoprosthetic repair of the knee joint. A number of authors state that spinal or combined spinal epidural anesthesia is the most adequate methods of intra- and postoperative anesthesia at general endoprosthetic repair of the knee joint.
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Anesteziol Reanimatol · Mar 2006
Randomized Controlled Trial[Effect of anesthesia with xenon and nitrous oxide with fentanyl on dynamics of cellular immunity and cytokines].
Immunological parameters were studied at randomization in 60 surgical patients during the similar operation--cholecystectomy made under combined endotracheal low-flow general anesthesia using N2O:O2+fentanyl in 32 patients and Xe:O2 in 28 patients. The time course of changes in cellular immunity and cytokines was closely related to the type of an anesthetic. ⋯ The differences in the action of the anesthetics were due to the fact that Xe had a greater narcotic potential, a protective action on neuroendocrine function, and no toxicity. Xe is indicated to patients with baseline immunodeficiency.
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Anesteziol Reanimatol · Mar 2006
Randomized Controlled Trial[Preoperative hypervolemic hemodilution with 6% hydroxyethyl starch 130/0,4 (HES 130/ 0.4) solution as a way of reducing needs for donor blood transfusion].
The efficacy of hypervolemic hemodilution (HHD) in reducing the rate of donor blood transfusion is controversely discussed. The present prospective, randomized, clinical study analyzes the impact of HHD with 6% hydroxyethyl starch (HES) 130/0.4 solution on the rate transfusion, laboratory parameters, and the incidence of complications as compared with those in the control group receiving no preoperative HHD. ⋯ Preoperative HHD in patients undergoing surgery with expected >30% blood loss leads to decreased needs for blood transfusion. The method is safe and easy-to-use.
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Anesteziol Reanimatol · Jan 2006
Comparative Study Clinical Trial[Induction of anesthesia with halogen-containing anesthetic agents in children].
The study has comparatively evaluated the effectiveness and safety of halothane, enflurane, and isoflurane in children during induction. Seventy hundred and eight patients aged 1-14 years who had ASA I-II anesthetic risks were examined. ⋯ The studies have established that in terms of comfort, safety, and the rate clinical effect achievement, the drugs of choice for gas induction in children are enflurane and, to a lesser extent, halothane. Gas induction with isoflurane should not be performed in children since the agent rather frequently exerts an irritant action on the upper airways, which reduces the speed of initial narcosis and increases the likelihood of one or another adverse reactions; however; it has advantages as a less hemodynamic effect.
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Forty-one children aged 4 to 15 years, who had been operated on for varicocele and hernias at various sites, were examined. Central hemodynamics, and the level of sedation and pain were assessed. Studies were performed in 2 groups of patients: 1) those who received anesthesia with ketamine in combination with propofol and 2) those who had inhalational-mask anesthesia using phtorotan in combination with nitrous oxide. They indicated that the patients more promptly emerged from phtorotan anesthesia; however, they require preventive analgesia.