Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2005
[Intraaortic balloon counterpulsation in the treatment of perioperative cardiogenic shock-complicated myocardial infarction during aortocoronary bypass surgery].
The paper presents the results of use of intraaortic balloon counterpulsation (IABC) in complex therapy for cardiogemic shock in 31 patients with perioperative myocardial infarction (PMI) developed during aortocoronary bypass surgery under extracorporeal circulation (EC) and cold cardioplegia. The diagnosis of PMI was confirmed by the ECG data (the emergence of new Q waves) and by the high level of CPC-MB (more than 6%). IABC was performed, by using a Kontron M-7000 apparatus. ⋯ Improvements in left ventricular pump function, cardiac output, and a significant reduction in the doses of sympathomimetics within the first 12 hours of IABC should be considered to be a good predictor. With the complex treatment of cardiogenic shock, by using counterpulsation after aortocoronary bypass surgery is 51.6%. The early initiation of IABC within 6 hours following the development of myocardial infarction allows mortality to be reduced.
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The paper analyzes the first experience in using the halogen-containing anesthetic sevoflurane, which is new for Russia, as an agent for initial narcosis and anesthesia maintenance in adult patients. For induction, delivery of sevoflurane was initiated in a dose of 0.7 r.% through the mask of an anesthetic-respiratory apparatus. After 3-5 breaths, the dose of sevoflurane was increased up to 2 r.%. ⋯ Sevofluorane has a pronounced hypnotic, but a weak analgesic effect in adults, which requires the co-administration of fentanyl. Sevofluorane will be mostly demanded for initial narcosis and anesthesia maintenance in children and for the induction and maintenance of anesthesia in ambulatory anesthesiology and thriving one-day hospitals. The foregoing does not rule out the use of servofluorane for the induction and maintenance of anesthesia in adults.
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Anesteziol Reanimatol · Mar 2005
[Use of continuous high-volume hemofiltration in patients with sepsis and multiple organ dysfunction].
The paper gives the authors' experience in performing continuous high-volume hemofiltration in 38 patients with sepsis and multiple organ failure. The kinetics of proinflammatory cytokines and a number of plasma enzymes as markers of substances having a relatively high molecular mass was studied. ⋯ The possibilities of correcting the parameters of homeostasis are the principles of maintenance of a hemostatic system in this group of patients during the procedure are presented. The drawbacks of this technique are also described.
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Anesteziol Reanimatol · Jan 2005
Comparative Study Clinical Trial[Effect of nonsteroidal anti-inflammatory drugs and paracetamol on hemodynamic changes during postoperative analgesia in children].
The purpose of the present study was to comparatively assess the adequacy of postoperative analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol in children undergone "minor" surgical interventions. For postoperative analgesia in children, the authors used paracetamol in a single dose of 25-30 mg/kg, diclofenac in a dose of 1.5-2.0 mg/kg, which were rectally administered as suppositories, as well as diclofenac in the same dose as intramuscular injections (Group 1). A comparison was made with postoperative analgesia using analgin and promedole (Group 2 (control)). ⋯ The efficiency of postoperative analgesia was evaluated, by using central hemodynamic parameters that many investigators consider to be one of the major criteria for the adequacy of anesthesia. Comparison of postoperative data has revealed a difference between the groups, which suggests that the use of NSAIDs and paracetamol for preventive and postoperative analgesia in children substantially improves the postoperative period and promotes a rapid rehabilitation in patients. Comparative analysis of the efficiency of postoperative analgesia of the above agents has indicated that diclofenac and paracetamol have a sufficient analgesic activity and at the same time do not show the adverse reactions unique to narcotic analgesics.
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Anesteziol Reanimatol · Jan 2005
Comparative Study[Inhalational anesthesia during adenoidectomy in children].
The paper deals with the comparison of inhalational anesthesia using a fluoroethane-monooxide-oxygen mixture in apparatus-mask and endotracheal fashions in children during adenotomy. Children aged 4 to 15 years, who had undergone apparatus-mask (n = 51) and endotracheal (n = 57) anesthesia, were examined. The patients were divided into two age groups: 4-8 years and 8-15 years. ⋯ In endotracheal fluoroethane-monooxide-oxygen anesthesia, the stability of cardiac output is maintained by the tension of more mature compensatory mechanisms responsible for regulation of central hemodynamics. A marked sympathicotony is noted at the traumatic stage of a surgery, as evidenced by cardiointervalography. There is motor agitation in the postoperative period.