Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2002
[Electroencephalogram, informational saturation of electroencephalogram, and bispectral index during xenon anesthesia for laparoscopic operations].
The depth of xenon anesthesia was never evaluated by modern methods of EEG monitoring, and hence, we studied changes in EEG, INEEG, and BIS during different stages of xenon narcosis and evaluated the possibility of using these values as criteria of xenon anesthesia adequacy. The study was carried out in 60 patients during laparoscopic operations on abdominal organs. The patients were divided into 2 groups receiving different gas anesthetics (xenon or nitric oxide). The results indicate that xenon monoanesthesia caused dose-dependent changes in the native and treated EEG; xenon is a good inhalation anesthetic providing adequate anesthesia for little traumatic operations even in case of mononarcosis; INEEG and BIS monitoring during xenon anesthesia allows an objective evaluation of its depth.
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Anesteziol Reanimatol · May 2002
[Target control infusion of propofol: is this method really preferable?].
In order to elucidate the advantages of target control infusion (TCI) over common manually controlled infusion, we evaluated the results of 54 anesthesias carried out at department of roentgeno-endovascular surgery. All 54 patients received intravenous controlled sedation with propofol. ⋯ Performed by a skilled anesthesiologist, both methods ensure sufficient comfort for the patient, stable hemodynamics, and easy regulation of the depth of sedation. However, TCI is more convenient for physician, and this is the reason why many specialists prefer it.
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Anesteziol Reanimatol · May 2002
[Propofol-based protocol of general anesthesia for operations in patients with severe burns with ASA class III-IV].
Use of propofol in surgery on critical patients is limited because of the possibility of poorly corrected hypotonia. The effects of total anesthesia with propofol + fentanyl + nitric oxide under conditions of artificial ventilation of the lungs (tracrium) were evaluated during 63 operations on 42 patients with severe burns (ASA III-IV), divided into 2 groups depending on the protocol of anesthesia. The difference in the protocols consisted in the method of choice of anesthetic doses: in group A we proceeded from EEG data (bispectral index--BIS) and in group B relied only on general clinical and hemodynamic signs with a retrospective analysis of BIS. ⋯ Simultaneous monitoring of BIS showed that the propofol dose needed for adequate induction narcosis with subsequent intubation should be higher than the dose usually recommended for patients with ASA class III-IV. Use of BIS monitoring during the operation resulted in a decrease of the propofol and fentanyl doses. The authors do not recommend decreasing the velocity of propofol infusion below 3 mg/kg/h (at FiN2) = 0.6) because of the risk of awakening during narcosis.
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The authors present their experience gained in anesthesias for resection of the liver. Methods for evaluating total liver blood flow by ueveredine dilution, portal blood flow by thermodilution, changes in arterial blood supply during and after the operation are discussed. Effects of methods of anesthesia on total liver blood flow and some parameters of systemic hemodynamics are analyzed. ⋯ The efficiencies of anesthesias for resection of the liver and their effects on liver function during and after the operation are evaluated. The results evidence that disorders in liver circulation parameters were far less pronounced in the patients operated on under Xe anesthesia in comparison with patients operated on under neuroleptanalgesia and calypsol anesthesia. The study confirmed a pronounced analgesic effect of xenon, and clinical results confirmed that Xe anesthesia can be used in traumatic interventions.
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Anesteziol Reanimatol · Mar 2002
Comparative Study[Systemic hemodynamics in constant hemofiltration in patients with septic shock].
Hemodiafiltration (HDF) is a method of pathogenetic therapy for the systemic inflammatory response syndrome in patients with sepsis and shock irrespective of renal failure. Systemic hemodynamics was examined in 18 patients with septic shock treated by HDF (2 groups). ⋯ An opposite tendency was observed in group 2 (refractory shock). Despite high (72.2%) mortality which was mainly caused by the progress of multiple organ dysfunction or untimely surgical intervention, it is obvious that HDF created conditions for surviving the critical period of disease in patients with progressive sepsis.