Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2004
[Hemodynamic parameters and saturation of the cerebral cortex blood with oxygen during extracorporeal circulation in heart surgery].
Sixty-three patients were intraoperatively examined during heart surgery with extracorporeal circulation (AEC). They were operated on for an affected heart-valve apparatus (AHVA) and ischemic heart disease (IHD). ⋯ A maximal saturation of the cortex blood with oxygen at AEC was registered in patients with AHVA at an average pressure below 70 mm Hg, and in patients with IHD--at 85 mm Hg. An increased pressure in BSJV at a constant mean arterial pressure and at AEC is related with blood outflow from the venous collector of the brain.
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Anesteziol Reanimatol · Sep 2004
[Safety and quality of myoplegia in different types of abdominal surgeries].
The efficiency of new non-depolarized myorelaxants, i.e. of rocuronium and cisatracurium, in abdominal surgery with general anesthesia (combined or total intravenous anesthesia) of 114 patients was evaluated clinically and accelerometrically. The use of the above drugs at 2 x ED95 was confirmed to ensure a high-quality myorelaxation in different surgery variations (laparoscopy or laparotomy). A lack of effect on the hemodynamics (according to continuous non-invasive monitoring) and release of histamine (according to radioimmunology assay) make it possible to use the myorelaxants in patients with concurrent cardiovascular disease and with burdened allergic history. A bigger degree of prognosticated effect duration is typical of cisatracurium versus rocuronium, whereas the latter is a myorelaxant of choice in case a fast trachea intubation is needed.
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Anesteziol Reanimatol · Sep 2004
[Anesthesiological problems in the surgical treatment of chronic obstructive pulmonary disease].
Maintenance of effective gas exchange made with respect to surgical comfort and lower risk of intraoperative lung damage is the main problem in the anesthetic management of surgical reduction of pulmonary volume (SRPV). Described in the paper is the experience of anesthetic management made in 10 patients in SPRV. The method of differential ALV (DALV) with continuous positive pressure in airways (CPPA) made for the ventilation support of the independent lung was found to be the only effective technique ensuring an adequate gas exchange in surgery for SPRV in patients with diffusive pulmonary emphysema (DPE). ⋯ At the same time, it provides for an optimal surgical comfort and for the most cautious manipulations on the lung. Such a combination improves the overall surgical results. The high-frequency respiratory support to the operated lung is contraindicated in such patients because of hyperinflation of the affected lung.
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Anesteziol Reanimatol · Sep 2004
[Pharmacoeconomic assessment of prevention of the postoperative nausea and vomiting syndrome in plastic (esthetic and reconstructive) surgery].
A comparative "cost-efficiency" pharmacoeconomic analysis was made for 5 different anti-emitting drugs, i.e. for "Navoban", "Zofran" (intravenous administration, 8 mg; and suppositories, 16 mg) and for "Metipred" (methylprednisolone) used in aesthetic and reconstructive surgeries of 86 patients. All the drugs were found to be effective for the prevention of PONV. Clinically, the efficiency decreased in the following order: "Novoban" and "Zofran" suppositories 16 mg, "Metiored" and "Zofran" intravenous administration 8 mg. As for "cost-efficiency", preference should be given to "Metipred".
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Anesteziol Reanimatol · Jul 2004
[An analysis of using the graphic monitoring of ventilation for an optimal choice of respiratory management parameters in patients with acute respiratory distress syndrome].
The potentialities of graphic ventilation monitoring (graphic monitor "Servo Screen 390", Siemens Elema, Sweden) were analyzed for optimizing the respiratory management parameters in 48 obstetric and gynecology patients with acute respiratory distress syndrome (ARDS). The ventilation loops and curves, ALV parameters, mechanical lung properties, gas blood composition and gas indices were dynamically evaluated during examination stages. The graphic ventilation monitoring, when used for respiratory management in patients with ARDS, provides for optimizing, in the real time mode, the PEEP and Vt levels, which is in line with the AVL "safety" concept.