Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2011
[Parameters of controlled mechanical lung ventilation and external respiratory function during thoracoscopic surgeries in children of different age groups].
The purpose of the study is to estimate the parameters of mechanical ventilation and respiratory function during videotorachoscopic surgeries in children. 73 anesthesias were conducted in children aged 5 to 16 years of age. During the study, a detailed monitoring of respiratory function and parameters of mechanical ventilation was carried out. Indicators reflecting the lung function remained stable in all phases of the study. ⋯ One-lung ventilation is safe under certain conditions: increasing FiO2 from 0.5 to 1, the reduction of tidal volume up to 5-5.3 ml/kg, the use of a size or a half size smaller cuffed endotracheal tubes for intubation of the right and left main bronchus compared to those for tracheal intubation. For the intubation of the right main bronchus the endotracheal tube with the Murphy eye should be used, for the means ventilation of the upper lobe of the right lung. If the minute volume of breathing is adequate and there is no preoperative hypercapnia, the elimination of CO2 for one-lung ventilation is not disrupted and the tension of CO2 in arterial blood increases.
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The study investigates the influence of Voluven 6% and HAES-steril 10% on the hemodynamics and organism water balance of 40 children from 3 months to 17 years of age, which were divided into two groups according to the type of the administered colloid. It is acquired that infusion of colloids with 1:3 ratio compared to crystalloids in general volume of infused liquids (Voluven 6% in the dose of 5 ml/kg/hour in case of median blood loss of 15% of the total circulating blood volume during two hour long surgery and HAES-steril 10% in the dose of 4 ml/kg/hour in case of the blood loss up to 25% of TCBV) allows to effectively neutralize hemodynamic changes based upon administration of anesthetic agents and intraoperative fluid loss. While administration of Voluven 6% is accompanied by significant, statistically accurate decrease of lower limb impedance, which indicates the increased amount of water in them, HAES-steril 10% administration leads to redistribution of water in the body segments with its predominant significant increase in the torso.
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Pharmacokinetics of fentanyl during sevoflurane based general anesthesia in children].
The research is based on the analysis of 50 cases of anesthesia during reconstructive surgeries in children. The anesthesia was based on inhalation of sevolflurane and injection of fentanyl by the bolus infusion scheme. ⋯ Infusion of fentanyl provided a smooth, gradual decrease in its concentration in plasma, while analgesia remained adequate. The combination of sevoflurane in a concentration of 1.3 MAC and infusion of fentanyl to a total dose 6 mkg/kg/h was effective in provisioning stable anesthesia in the given category of patients with surgical pathology.
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Postoperative analgesia of newborns using local anesthetic administered through wound irrigation catheter of permanent action].
The analysis of publications is devoted to the application of skin conductance monitoring in anesthesiology and intensive care. Rates of skin conductance (baseline values, the amplitude and frequency of the waves) are closely linked with the state of the sympathic nervous system. According to their dynamics it is possible to judge on the pain and stress in patients with whom the contact is difficult: newborns, infants, patients of all age groups during general anesthesia and in critical condition. According to published data monitoring skin conductance showed itself as a sensitive and promising method to identify and determine the severity of pain in all age groups, approaching by its characteristics the theses of the pain assessment perfect tool.
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Effect of anesthesia on neurological status of newborns in abdominal delivery during early postnatal period].
The publication is devoted to the case of the successful application of alveolus mobilization maneuver in infants with respiratory distress syndrome and demonstrates the high clinical efficacy of this method of respiratory support, not only during expressed hypoxemia, but also during hypercapnic respiratory failure.