Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 1997
Review Comparative Study[Spinal anesthesia: a step backward or a step forward?].
The authors analyze the evolution of methods of segmentary blocking over 100 years of their application. They compare the potentialities of and indications for epidural and spinal anesthesia. ⋯ The authors analyze the surgical pathophysiology of a segmentary conduction block and compare the efficacy of protection from operation stress under total and segmentary anesthesia and the structure and incidence of intra- and postoperative complications. They validate the perspectives of spinal anesthesia methods which can be widely used in practical anesthesiology.
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Anesteziol Reanimatol · Sep 1997
Comparative Study Clinical Trial Controlled Clinical Trial[Use of combined lidocaine and bupivacaine spinal-epidural anesthesia in vascular surgery of lower limbs].
The efficacy of combined spinal epidural anesthesia (CSEA) for femoral to distal artery bypass surgery is assessed. Thirty-eight patients were divided into 3 groups. CSE block was performed at L3-L4 (26G pensil-point spinal needle and 18G catheter). ⋯ No neurological problems or PDPH were observed in any of the patients and no vasoactive drugs were needed. CSEA is fit for anesthesia for peripheral vascular surgery. CSEA with double spinal injection is preferable, for it provides a longer anesthesia and hemodynamic stability.
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Anesteziol Reanimatol · Sep 1997
Case Reports[Fiberoptic bronchoscopy via laryngeal mask in children].
A fiberoptic bronchoscope provides a good access to the distal airways, inaccessible for a rigid bronchoscope. A major disadvantage of the fiberoptic bronchoscope in tracheal intubation of children is its little diameter, impeding the instrumentation and suction. ⋯ A relatively large internal diameter of LM permits ventilation round the fiberoptic bronchoscope. The method is atraumatic and represents a good alternative to the rigid bronchoscope in children.
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Anesteziol Reanimatol · Sep 1997
Comparative Study[Noninvasive mask ventilation of the lungs in the treatment of acute respiratory insufficiency in heart surgery patients in the postoperative period].
Noninvasive ventilation of the lungs using a mask (NIVLM) was used in 54 patients with hypercapnic (n = 14) and hypoxemic (n = 40) respiratory failure. Respironics (USA) nasal and facial masks were applied. Ventilation regimens were selected individually. ⋯ In general, the efficacy of NIVLM was 91%, but resolution of respiratory failure without repeated intubation of the trachea was attained in only 33 patients (87%) with the hypoxemic condition. The mean duration of NIVLM in this group was 464 +/- 47 min. Hence, NIVLM is an effective method for respiratory support in patients with both hypoxemic and hypercapnic respiratory failure, which helps decrease the duration of forced ventilation of the lungs or do without repeated intubation of the trachea.
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Anesteziol Reanimatol · Sep 1997
Comparative Study[Clinical, neurophysiological and hemodynamic effects of a new nondepolarizing myorelaxant mivacurium in heart surgery patients].
Thirty patients aged 23 to 65 years with ASA class III operated on the heart under total intravenous anesthesia were examined after the Good Clinical Practice protocol. Mivacurium in bolus dose of 0.2 mg/kg was injected for intubation of the trachea; neuromuscular blocking (NMB) was maintained by a repeated injection of the drug in a dose of 0.15 mg/kg, after which it was infused at a rate of 1 to 10 micrograms/kg/min. Accelerometric control of neuromuscular conduction was carried out by the Organon (Belgium) TOF-Guard device. ⋯ Repeated bolus injection of the drug in a dose of 0.15 mg/kg and its infusion did not change the peripheral and central hemodynamics. The most typical side effect of the drug in a dose of 0.2 mg/kg is short-term reversible reddening of the skin of the face and neck, observed in 20% of patients. The results permit us to consider mivacurium as an effective, safe, and controllable agent, which can be used in cardiosurgical patients.