Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2013
Case Reports[Case of successful thrombolytic therapy in complex cardio-pulmonary resuscitation for massive pulmonary thromboembolism in parturient after elective caesarian operation].
Pulmonary thromboembolism is a main cause of parturient mortality in the world. Recently there are few reports about a thrombolytic therapy use in parturient in medical publications. The article deals with a case of successful application of thrombolysis in a complex cardio-pulmonary resuscitation in parturient with massive pulmonary thromboembolism. ⋯ Cerebral edema was diagnosed by computed tomography. Consciousness occurred on the fourth day and the woman was weaned from the ventilator on the fifth day. The patient was discharged from the hospital on 20th day without neurological complications.
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Anesteziol Reanimatol · Nov 2013
Observational Study[Comparison of epidural and opioid analgesia effects on frequency of paralytic ileus development in patients of surgical intensive care unit].
The impact of epidural analgesia (EA) on bowel peristalsis in Surgical Intensive Care Unit (SICU) patients is not well known. This study was designed to determine if EA improves bowel motility and decreases the incidence of postoperative paralytic ileus compared to patients receiving systemic opioid analgesia (OA). Through prospective cohort study we investigated 386 SICU patients who received EA [n = 70 (18.13%)], or OA +/- ketorolac trometamol [n = 316 (81.87%)]. We showed that EA does not improve time to defecation and does not decrease the incidence of paralytic ileus in SICU patients.
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Anesteziol Reanimatol · Nov 2013
[Effect of anaesthesia on incidence of postoperative delirium after major abdominal surgery in elderly patients].
Delirium can be caused by haemodynamics abnormalities during anaesthesia. The main role in delirium appearance is given to decreasing of cerebral perfusion pressure. Especially it can happen in patients with underlying intracranial hypertension. ⋯ The frequency of delirium was higher in patients who had got anaesthesia based on sevoflurane. Additionally these patients had higher frequency of cerebral perfusion pressure decreasing. Conclusions; Anaesthesia based on sevoflurane is characterized by higher frequency of postoperative delirium in elderly patients after major abdominal surgery.
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Anesteziol Reanimatol · Sep 2013
[Assessment of anaesthesia sufficiency and stress response during liver resections].
Recently number of patients undergoing a surgery for primary and secondary liver damages is increased. Thus an adequate and safe anaesthesiological care for the surgeries is a very actual problem. The article deals with a study of anaesthesiological care in 51 patients. 26 patients (51%) received multimodal balanced anaesthesia based on sevoflurane and 25 patients (49%) received multimodal balanced anaesthesia based on continuous propofol infusion. ⋯ This fact shows that propofol provides stronger protection than sevoflurane. Adequate level of anaesthesia does not cause outoregulative mechanisms suppression which is important during strongly traumatic surgery. Anaesthesia based on sevoflurane both to anaesthesia based on continuous propofol infusion is a method of choice for liver resection.