Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2007
Randomized Controlled Trial[Procedures for preventing postoperative nausea and vomiting after laparoscopic cholecystectomy: dexamethasone and ondansetron].
This randomized double-blind study was undertaken to evaluate the efficacy of ondasetron and dexamathesone in reducing the incidence of postoperative nausea and vomiting after laparoscopic cholecystectomy. The study covered 60 patients (ASA I/II) who had undergone laparoscopic cholecystectomy under general anesthesia. The patients were divided into two groups: 1) 30 patients who received dexamethasone, 4 mg i.v.; and 2) 30 patients who took ondansetron, 4 mg i.v., prior to general anesthesia. ⋯ The least intensity of postoperative pain was observed in Group 1, but the difference between the study groups was insignificant. It is concluded that dexamethasone is more effective in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy than ondansetron. This is mainly determined by a significant reduction in the incidence of postoperative nausea.
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Anesteziol Reanimatol · Mar 2007
Comparative Study Clinical Trial[Sevoflurane and isoflurane during thoracic operations under artificial one-lung ventilation in patients at a high surgical and anesthesiological risk].
The specific features of balanced anesthesia utilizing sevoflurane (versus isoflurane) during thoracic operations under artificial one-lung ventilation (AOL ) have been studied in patients at high operative and anesthetic risks. Unlike isoflurane, sevflurane fails to cause vasodilatation in both the greater and lesser circulation (including in the gas-exchange part ofpulmonary circulation). The difference of the anesthetics in their vasodilating capacity in the vessels of pulmonary and systemic circulation determines various mechanisms of pathophysiological and adaptive circulatory changes in pulmonary collapse and under AOL V Under sevoflurane anesthesia, compensatory blood flow limitation along the collaborated lung due to permanently vasohypertension in gas-exchange microcirculation is accompanied by a systemic circulatory response that is aimed at reducing right ventricular load. ⋯ The latter differentiates sevoflurane anesthesia from isoflurane one wherein completion of pulmonary hypoxic vasoconstriction upon 80-125-min exposure to AOL V results in the recovery of gas exchange to the baseline levels. The pattern of reperfusion changes in ventilation emergence in the operated lung under anesthesia using both sevoflurane and isoflurane is of no significant pathological tinge and it is followed by no pulmonary and systemic metabolic disturbances. Isoflurane should be recognized to be preferable component at the stage of anesthesia maintenance in patients with cardiopulmonary diseases during thoracic operations under prolonged AOL V (more than 2 hours).
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Anesteziol Reanimatol · Mar 2007
Comparative Study[Conduction analgesic techniques and a problem in safe anesthesia].
The authors analyze mortality rates during 338,000 anesthetic procedures. Mortality was 0.02%. Epidural, spinal, and plexus anesthesias were 15% of the total number of anesthetic procedures. ⋯ Under regional anesthesia, all deaths were associated with the induction of epidural anesthesia. A human factor is of profound importance for fatal cases under regional anesthesia. Regional anesthetic techniques are safer than general anesthetic ones.
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Anesteziol Reanimatol · Mar 2007
[Prognostic value of the pattern of multiple organ dysfunctions in severe acute pancreatitis].
A relationship was studied between the outcomes of severe acute pancreatitis and the pattern and multiple organ dysfunctions in 72 patients. Organ dysfunction was observed in 39 (54.2%) patients: multiple organ dysfunction (MOD) in 20 (27.8%) patients and dysfunction of an organ or a system in 19 (26.4%). The deceased patients had a statistically significantly higher incidence of MOS than the survivors (88.2% versus 9.1%; p < 0.01). Logistic regression showed that only respiratory and neurological dysfunctions were the factors that predispose to death.