Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2010
Clinical Trial[Optimization of anesthetic maintenance using two-channel laryngeal masks Proseal during endovascular correction of congenital defects in infants and young children].
The paper analyzes the efficiency of the authors' procedure for anesthetic maintenance based on a combination of inhalational (sevoflurane) and intravenous (1% propofol) anesthesia on spontaneous breathing through a ProSeal laryngeal mask airway in the X-ray endovascular correction of congenital heart diseases in infants and young children. The study included 118 children aged 2 to 7 years with secondary atrial septal defect, who had undergone endovascular defect correction, by applying an Amplazer septal occluder. The key points of the anesthetic maintenance proposed by the authors are: (1) substitution of routine pharmacological premedication for psychological (the presence of parents); (2) inhalational (sevoflurane) anesthesia in the induction of anesthesia; (3) replacement of an endotracheal tube by a ProSeal laryngeal mask; (4) refusal of myorelaxants and respiratory support without artificial ventilation. The authors' anesthesia protocol during these operations provides a safe perioperative period.
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Anesteziol Reanimatol · Mar 2010
Clinical Trial[Use of levosimendan in cardiosurgical patients with chronic heart insufficiency].
The impact of administration of the calcium sensitizer levosimendan on hemodynamic parameters, dose of intraoperative and postoperative cardiotonic maintenance, length of intensive care unit stay, and hospital mortality was studied in cardiosurgical patients with dilated cardiomyopathy, second-fourth degree mitral valve insufficiency, or NYHA Class IV circulatory insufficiency. Levosimendan was administered to 25 patients 3-5 days prior to surgery. ⋯ The use of the agent caused statistically significant reductions in pulmonary artery pressure and pulmonary wedge pressure and increases in cardiac index and left ventricular ejection fraction. The levosimedan-treated patients needed smaller doses of sjmpathomimetics, less length of intensive care unit stay and showed lower mortality rates (p < O.05 for all indices).
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Anesteziol Reanimatol · Mar 2010
Clinical Trial[Comparative assessment of various general anesthesia methods during reconstructive operations on the carotid arteries].
Total intravenous anesthesia with diprivan and inhaled sevoflurane was assessed in 130 patients undergoing carotid endartectomy. The parameters of hemodynamics and cerebral circulation and the markers of brain lesion were studied. Sevoflurane anesthesia was shown to induce less depression of hemodynamic parameters and to maintain the more optimal level of cerebral circulation, limiting brain ischemic and reperfusion lesions and causing a fewer number of postoperative complications.
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Anesteziol Reanimatol · Mar 2010
Clinical Trial[Anesthetic maintenance during circular face lifting].
The paper deals with the specific features of anesthetic maintenance (ketamine, diprivan, dormicum, perfalgan, promedol) during circular face lifting without artificial ventilation. All intravenous anesthesia procedures have yielded good results. ⋯ The use of perfalgan causes no hallucinogenic reactions and offers the optimum level of anesthesia. During face lifting, 2.3 +/- 0.6-hour anesthesia with spontaneous breathing is possible, safe, and warranted.
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Anesteziol Reanimatol · Mar 2010
Case Reports[Acute intracranial hypertension during xenon anesthesia in a patient with a giant brainstem tumor and cerebrospinal fluid flow obstruction: a case report].
Today there are prospects for the wide use of xenon for anesthesia or analgesic sedation in neurosurgical patients, but clinical trials of and experience in using the agent in neurosurgery are scanty. The paper reports the first case of acute intracranial hypertension during xenon anesthesia in a patient with a giant brain base tumor and cerebrospinal fluid flow obstruction in the presence of subcompensated intracranial hypertension. Comparison of intracranial pressure, blood pressure, cerebral perfusion pressure, and linear blood flow velocity suggests the nature of the effect of xenon on cerebral vascular tone, cerebral blood flow, and its autoregulation. Based on the findings, the authors discuss whether xenon may be used in patients with intracranial hypertension.