Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2007
Controlled Clinical Trial[Combined spinal epidural anesthesia in abdominal surgery].
The use of combined spinal epidural anesthesia (CSEA) in 37 patients during operations on abdominal organs has revealed a number of advantages of the procedure over endotracheal anesthesia. CSEA reduces the consumption of analgesics and myorelaxants and the time of postoperative artificial ventilation and offers the prospect of more qualitative analgesia.
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Anesteziol Reanimatol · May 2007
[Infectious complications after brain tumor removal: some aspects of their prevention, diagnosis, and treatment].
A hundred and fifty-five case histories of neurosurgical patients with the complicated early postoperative period were analyzed. Early postoperative regional pyoinflammatory complications were developed in 21 (4.4%) of 481 patients. There was meningitis in 17 (3.5%) cases, ventriculitis in 2 (0.4%), and wound infection (skin flap suppuration and postoperative wound fistula). ⋯ Among them, there were pyoinflammatory complications in the respiratory system in 30 (6.2%) cases, pyonecrotic cystitis in 5 (1%), and sepsis in 2 (0.4%). Risk factors for regional and systemic complications are shown. Based on the findings, recommendations are given to prevent and treat pyoseptic complications in neurosurgical patients.
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Anesteziol Reanimatol · May 2007
Review[Nutritional support in critical conditions as intensive care technology].
The patients of intensive care units represent a group in which nutritional support methods, such as enteral and parenteral feeding, are most frequently used to correct protein and energy metabolisms. The purpose of this paper is to analyze the most significant clinical problems ensuing in nutritional support in an intensive care unit, such as the high incidence of hospital exhaustion, difficulties in metabolic monitoring and in the determination of patients' needs for nutrients, in the choice for media for intravenous and enteral feeding, in the prevention of possible complications of nutritional support; organizational aspects.
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Anesteziol Reanimatol · May 2007
Randomized Controlled Trial Comparative Study[Efficacy of various epidural analgesia regimens after lung surgery].
A prospective study included 90 adult patients undergoing thoracic surgery. After placing an epidural catheter at the Th4-Th5 level, all the patients were randomized in 3 groups. Twenty-nine patients received controlled epidural analgesia (PCEA) with fentanyl, 2 microg/ml, in 0.2% bupivacaine solution (Group 1). ⋯ Opioid-induced pruritus was mostly (23%) observed in Group 2. Thoracic PCEA with fentanyl-bupivacaine solution provided adequate postoperative analgesia after thoracotomy and reduced the need for opioids. In addition, PCEA reduced the incidence of adverse reactions of opioids.