Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2011
[Bilateral bispectral index monitoring during surgery for posterior cranial fossa tumors].
The analysis of the results of bilateral monitoring of the depth of anesthesia in 22 patients with neurosurgical pathology of the posterior cranial fossa using the technique bispectral index (BIS). The results showed that more than half of the observations (at 19 and 22 patients) during the main phase of the operation (removal of the tumor) were observed differences in the BIS index values between the right and left side. In 1/3 of patients, these differences were driven by higher values of BIS on the side of surgery. By the end of removal of the tumor and, particularly, by the end of surgery there was a complete alignment of values of the BIS on the right and left.
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Anesteziol Reanimatol · Mar 2011
Clinical Trial[Paracetamol (perfalgane) as analgesic component of medicinal sedation].
This article reviews the possibility of the use of paracetamol (perfalgane) as an analgesic component of medical sedation. The actuality of the problem is the choice effective pharmacological means of protection from peri-operative pain. The theoretical advantages of paracetamol in the scheme of sedoanalgesia are exquisite. ⋯ The sedative agent in both groups was midazolam. It turned out, that despite the high efficacy of tramadol as a component of sedoanalgesia, the quality of anialgesia when using perfalagane is almost 5 times higher, both due to the significant number of good results, and to reduced number of adverse events. Use of paracetamol (Perfalgane) instead of tramadol for medical sedation during fibrotracheoscopy in patients in the early postoperative period leads to better quality of analgesia, thus avoiding such undesirable phenomena as hypersedation, respiratory depression, dizziness, and nausea.
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Using the mass spectrometric method we studied the interaction of volatile anesthetic sevoflurane with a CO2 absorber during low flow anesthesia (0.5 l/min fresh gas mixture). The results of measurements of sevoflurane and one of the most toxic breakdown products of sevoflurane CF = C(CF3)-O-CH2F (substance A) throughout the anesthesia in the mode of inhalation-exhalation. The highest recorded concentration of substance A was 65 ppm. Biochemical analysis of blood before and after anesthesia did not show connection with nephropathy and function of liver toxicity.
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Anesteziol Reanimatol · Jan 2011
Review[Controlled mechanical lung ventilation with guaranteed volume in newborns].
Mechanical ventilation with guaranteed volumes combines advantages of time-cyclic ventilation with limitation of pressure and constant flow, with volume control ventilation. This symbiosis allows to choose the optimal, stable breathing volume of the newborn, while maintaining pressure control. The review presents the principles of work, the main advantages and limitations of ventilation systems with the guaranteed volumes, as well as results and analysis of studies.
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Myoplegia during laparascopic surgeries in children].
The purpose of the study is to optimize the general anesthesia for laparoscopic surgery in children with rokuronium bromide. We investigated the effect of rokuronium on children from 3 to 17 years of age who underwent laparoscopic surgery for up to one hour in the department of anesthesiology and resuscitation of Tushino City Pediatric Hospital. The study included 31 children rated ASA I-II. ⋯ For the most rapid and comfortable tracheal intubation the optimal combination is rocuronium in a dose of 0.6 mg/kg (2 * ED90) with sevoflurane (52 + 7.7 sec). This method can be applied to case of emergency need for endotracheal intubation. Regardless of the anesthetic, the recovery time of the neuromuscular conduction changes inconsiderably reaching the secure level of TOF? 70% at laparoscopic operations for up to one hour, after which it is possible extubate the patient, which suggests t the predictability of rocuronium.