Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2009
Randomized Controlled Trial[Balanced postoperative analgesia in abdominal surgery: efficiency of the combined use of epidural block and non-opioid analgesics].
One hundred patients who had undergone elective surgery for abdominal malignancy were enrolled in the randomized, controlled study. Postoperative analgesia included only continuous epidural analgesia (PEA) or PEA with intramuscular ketorolac, or PEA with intramuscular ketorolac and intravenous paracetamol. The systemic use of ketorolac and paracetamol in addition to continuous epidural anesthesia can reduce a need for a local anesthetic and the intensity of postoperative movement pain.
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Anesteziol Reanimatol · Mar 2009
Comparative Study[Comparative assessment of electroencephalographic readings and perfusion index in patients in the perioperative period and coma].
Different monitoring modes are used to estimate the depth of anesthesia. Electroencephalography (EEG) is employed as a method of an electrophysiological study of brain function both during anesthesia and at the neuroresuscitative stage and changes in the peripheral vascular bed are evaluated by means of the perfusion index (PI). The purpose of the study was to comparatively analyze the use of EEG readings and PI at different stages of surgery and in coma of various etiologies. ⋯ The association established between the changes in EEG reading and PI in the perioperative period allows estimation of the depth and adequacy of anesthesia, by analyzing the changes in both EEG and PI. Unlike central hemodynamic parameters, PI shows an earlier response to nociception. Group 2 patients had also synchronous changes in EEG and PI characteristics in various clinical conditions.
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Anesteziol Reanimatol · Mar 2009
[Professional selection and successful residency training in anesthesiology-resuscitation].
The professional carrier of 356 residents, the 1960-2007 graduates of the Saint Petersburg Medical Academy of Postgraduate Education, was studied to specify approaches to professional selection of anesthesiologists. Thirty (8.4%) graduates did not work as anesthesiologists at all. It should be noted that most (n = 24) of the 30 graduates had successfully completed the residency. ⋯ However, it is impossible to consider each residency graduate to be a well-trained anesthesiologist. An intermediate decision to solve this problem is to establish the new nationally accepted order: a graduate may start his/her professional career only at a university clinic or other large hospital especially licensed for this purpose, by being supervised by senior colleagues. Permission for fully independent practice should be given not earlier than after 2-3-year work at the above mentioned clinics.
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Anesteziol Reanimatol · Mar 2009
[Potentialities of non-invasive hemodynamic monitoring in patients with acute destructive pancreatitis].
The potentialities of non-invasive hemodynamic monitoring were estimated in 49 patients with acute destructive pancreatitis in the postoperative period. Cardiac performance monitoring according to the results of which the patients were divided into 2 groups was analyzed. The low cardiac output values persisting within 10-12 days following the first operation were indicative of the severity of destruction processes and the high risk of complications. The simplicity, comparative low prices, initial computerization and non-invasive pattern make remonitoring an optimal source of information on hemodynamics in this cohort of patients.