Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 1995
Comparative Study[Myocardial protection from ischemic and reperfusion injuries in reconstructive heart surgery].
Methods of myocardial protection from ischemic and reperfusion injuries in various operations on the open heart were compared. The study demonstrated the advantages of combined antegrade-retrograde delivery of cardioplegic solution during ischemia in aortocoronary shunting and correction of valvular defects. The method of myocardial protection from reperfusion injury by perfusing the heart with blood solution of a special composition before removing the clamp from the aorta (controlled reperfusion) proved to be effective, which was confirmed by clinical and biochemical data presented in this paper. Hence, our findings confirmed that the optimal protection of the myocardium can be attained by combined cold crystalloid cardioplegia together with controlled reperfusion of the myocardium.
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Anesteziol Reanimatol · Mar 1995
Comparative Study[Adequacy of amputation analgesia as a factor preventing the triggering of pain memory in the genesis of phantom pain syndrome].
Examinations of 72 patients with a history of amputation of the lower limb showed that preamputation pain may be transformed into phantom pain via "pain memory" mechanisms. This fact is confirmed by similarity of the verbal structure of preamputation pain and phantom pain syndrome, which are particularly expressed in the patients operated on under total anesthesia. ⋯ Prolonged epidural anesthesia provides a pain-free period before surgery by disrupting the time relationship between nociceptive impulsation entry in the CNS structures and amputation, thus preventing fixation of 'pain experience' survived in the memory. The adequacy of intraoperative analgesia attained by prolonged epidural anesthesia plays the crucial role in prevention of realization of the "pain memory" effect.
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Anesteziol Reanimatol · Mar 1995
Comparative Study[Personal computer-based computer monitoring system of the anesthesiologist (2-year experience in development and use)].
Creation of computer monitoring systems (CMS) for operating rooms is one of the most important spheres of personal computer employment in anesthesiology. The authors developed a PC RS/AT-based CMS and effectively used it for more than 2 years. ⋯ The possibility to assess brain function by computer monitoring the EEF simultaneously with central hemodynamics and body temperature permit the anesthesiologist to objectively assess the depth of anesthesia and to diagnose cerebral hypoxia. Automated anesthesiological chart issued by the CMS after surgery reliably reflects the patient's status and the measures taken by the anesthesiologist.
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Anesteziol Reanimatol · Mar 1995
Comparative Study[Acupuncture analgesia and analgesic transcutaneous electroneurostimulation in the early postoperative period].
Efficacies of two methods of nondrug analgesia: acupuncture (1000 cases) and antipain transcutaneous electroneurostimulation (91 cases), as well as of narcotic analgesics omnopon and promedol (229 cases) were compared in the immediate and early postoperative period. In 229 cases acupuncture was used for the treatment of other functional complications of the postoperative period. ⋯ Acupuncture, though less effective than narcotic analgesics, helped arrest or noticeably alleviate the severity of such postoperative complications as reflex retention of the urine, impairment of hte drainage function of the bronchi, intestinal paresis, bronchial asthma, vomiting, nausea, pain or itching in the stoma, chill, hyperthermia in 43 to 81% of cases. The authors come to a conclusion on the desirability of an integrative approach (combined use of drugs and nondrug methods of analgesia) in the management of postoperative pain.