Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2002
Comparative Study[Postoperative period in early activated patients after myocardial revascularization].
The specific features of an early postoperative period were studied in 115 patients undergone myocardial revascularization who were divided into 3 groups according to the time of postoperative activation. Group 1 comprised 35 patients in whom tracheal extubation was made in the operating room 30-60 min after the end of the operation. Group 2 included 32 patients extubated 2-8 hours after admission to the resuscitation and intensive care unit (RICU); Group 3 consisted of 48 patients undergone tracheal intubation for more than 8 hours. ⋯ In Group 1, the frequency of reintubations for arterial hypoxemias was 2.8% and that of pneumonias and pulmonary microatelectasis was 2.5 times less as that in Group 3 (9%, p < 0.05). Chills occurred in 6, 4, and 15% of cases in Groups 1, 2, and 3, respectively (p < 0.05). A programme on early activation after aortocoronary bypass surgery could reduce the patients' stay at the RICU on an average by 24 hours without increasing the risk for postoperative complications.
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Anesteziol Reanimatol · Sep 2002
Comparative Study[Carboxyperitoneum and clinical efficacy of nondepolarizing relaxants with different types of metabolism].
A total of 108 patients operated on the abdominal cavity were examined with laparoscopic equipment or via laparotomic assess. The recovery time of neuromuscular conduction was defined for a myorelaxant with organ-depended metabolism (pipecuronium) and, predominantly, nonorgan-depended metabolism (athracurium and cisathracurium) in relation to the type of surgical technique (laparoscopy and laparotomy). It is concluded that carboxyperitoneum prolongs the recovery of neuromuscular conduction for pipecuronium without affecting this parameter in athracurium and cisathracurium. It is more expedient to use these myorelaxants during laparoscopic operations than pipecuronium, a myorelaxant having organ-dependent metabolism.
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Anesteziol Reanimatol · Sep 2002
Comparative Study[Optimization of anesthesiological maintenance of x-ray surgical interventions in children].
Two procedures for intravenous anesthesia during X-ray surgical interventions were evaluated in 38 children aged 3 to 13 years. Initial anesthesia (with intramuscular midazole and ketamine), followed by the fractional use of the latter agents in Group 1 and propofol in Group 2, in order to maintain anesthesia. Blood pressure (BP) (noninvasively), heart rate (HR), SpO2, and respiratory rate (RR) were monitored. ⋯ In Group these changes retained throughout the basic stage of intervention. In Group 2 on propofol infusion, BPmean and HR returned to normal values and remained at this level till the end of the intervention, SpO2 and RR did not differ from the baseline values in both groups. Thus, a combination of intravenous ketamine and intramuscular propofol provides steady-state values of BP and HR at the basic state of X-ray surgical intervention in children, which increases the reliability of studies and surgical safety in patients.
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Clinical and electrophysiological studies were performed in 10 volunteers and 45 patients with Classes I and II, as stated by the American Society of Anesthesiologists, to evaluate consciousness during sedation. Prior studies on volunteers showed that there was a clear correlation between N-REM sleep and SEF in 90% of cases. Based on these findings, the authors propose a modified suppressed consciousness scale whose rating was adjusted to the levels of N-REM sleep. Irrespective of the type and technique of sedation (infusion of thiopental and propofol; PCS, midazolam), changes in the levels of drug-depressed consciousness were found to be the same.
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Anesteziol Reanimatol · Sep 2002
[Prevention of postoperative nausea and vomiting with highly selective 5-HT3 serotonin receptors antagonists during different types of surgery].
A prospective study was conducted to examine the efficacy of highly selective, 5-HT3 serotonin receptor antagonists (Zofran, 4 mg; Latran, 4 and 8 mg; Navoban, 2 and 5 mg) during plastic and abdominal (endoscopic and routine) interventions in 165 patients aged 14 to 77 years who had ASA Classes I-III. The drugs caused no adverse reactions and were effective in controlling postoperative nausea and vomiting (PONV) after surgery under total intravenous anesthesia. ⋯ Risk factors for PONV are analyzed. The pathophysiological aspects of PONV and practical approaches to making an antiemetic strategy are discussed.