Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Preventive analgesia: true of preventing the postoperative pain syndrome].
A total of 152 patients subjected to operations mainly of an orthopaedic profile were divided into 8 groups for the development of the optimal method of preventive analgesia. The best results were attained by combined use of opiate premedication, regional blocking as a component of anesthesiologic care, and parenteral diclophenak-Na before and after the operation. 31.5% of patients in this group did not need any postoperative analgesia. ⋯ Preventive analgesia reduced the incidence of phantom pain syndrome after limb amputation in patients with the preamputation pain from 63.3 to 25.1%. The postoperative pain syndrome may be prevented if the factors determining it (preoperative pain, intraoperative nociceptive stimulation, and perioperative tissue inflammation) are eliminated simultaneously.
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Anesteziol Reanimatol · Jul 1996
[Monitoring of the informative saturation of EEG: a new method for intraoperative assessment of antinociceptive defense of the organism].
EEG is the result of brain activity aimed at processing the external and internal information. Intraoperative pain (as a specific type of information) developing because of inadequate anesthesia increases the total amount of information on the EEG. A new original method is proposed for assessing the efficacy of analgesia, based on computer monitoring of information saturation of EEG in the on-line regimen during an operative intervention under combined total anesthesia. Physiological and clinical significance of the detected phenomena is discussed.
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Anesteziol Reanimatol · Jul 1996
Review[Regional (conduction) anesthesia: new solutions of old problems].
Despite the constant improvements, local and total anesthesia are often regarded as alternative methods while selecting anesthesia. Modern anesthesiology aiming at the maximal regulation and safety of anesthesiological care, by no means confined to mere analgesia, clearly demonstrated the disagreement between the traditional approach to local anesthesia and the practical requirements. It is obvious that today we can speak about a revision of our attitude to local anesthesia. ⋯ The authors consider that at present the strategic problem of regional anesthesia-regulation and safety of its pharmacological effects-is solved. Such anesthesia is as readily regulated as different variants of total anesthesia, and it may be even safer. This permitted not only extending the indications to regional anesthesia, but using the selective effects of regional blocking as the main or special component of anesthesiology.
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Anesteziol Reanimatol · Jul 1996
[Endoscopic method for the diagnosis and treatment of spinal pain syndromes].
The endoscopy of the epidural space-"Epiduroscopy"-is a new imaging technique in the diagnosis and therapy of spinal pain syndrome. For investigation of the epidural space either a steerable or controllable flexible endoscope with an outer diameter of 2.5 mm and a working channel or a flexible catheter-secured epiduroscope unit can be used. ⋯ Due to epiduroscopy an epidural catheter could be placed safely in patients with chronic pain syndromes for a continuous intrathecal application of opioids or a precise epidural adhesiolysis. Percutaneous epiduroscopy, a new invasive micro-endoscopic technology, enables the extension of therapeutic potentials in chronic pain syndromes in addition to the diagnosis.