Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2001
Review[Anesthesiology consulting unit in perioperative medicine].
There is a demand, caused by increase of one-day surgery, surgery of high risk patients with coexisting diseases, and growing need for patient education, for such improvement of preoperative preparation, which will enable an optimalization in patient care. That became a special task of Preanesthetic Evaluation Clinic. The aim of the paper was to analyze activity of local Preanesthetic Evaluation Clinic in years 1993-2000. ⋯ As conclusions perspectives of further development of the Clinic were shown. Growing significance of an anesthetic nurse in perioperative patient preparation was foreseen. A demand for improving electronic patient records as well as use of new technologies was proven.
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Folia medica Cracoviensia · Jan 2001
Review[Qualification of patients for procedures to resect lung parenchyma during general anesthesia].
Authors described the methods and techniques of pulmonary and circulatory assessment of patients undergoing pulmonary resection. The most emphasis has been put on the perioperative management specially in patients with compromised pulmonary and circulatory system.
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Folia medica Cracoviensia · Jan 2001
Review[The role of infusion fluids and blood derived preparations during the perioperative period].
The treatment with infusion fluids in perioperative period is a basic therapeutic method. Depending on clinical situation, the doctor has various fluids available, both blood-replacing, and blood-derived. The number of crystaloid and colloidal fluids used has been systematically growing in two last decades. ⋯ The use of fresh frozen plasma (FFP) is the first step in the treatment of pathological bleeding in surgically treated patients. The occurrence of thrombocytopenia shows great individual variability. Thrombocyte concentrate transfusion should be performed after laboratory determination of thrombocyte count.
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Folia medica Cracoviensia · Jan 2001
Clinical Trial Controlled Clinical Trial[The effect of small doses of 7.5% NaCl on brain bulk during elective craniotomies].
In 16 patients (ASA I i II) aged 16-76 years (48 +/- 15; mean +/- SD) operated on because of intracranial expanding mass, the effect of hypertonic saline (7.5%--1 ml/kg b.w.) on brain bulk (BB) was evaluated. Patients were anaesthetised with a slight hypocarbia (PaCO2 = 33.3 +/- 3.5 mmHg). BB was scored after opening the dura (T0) and 15 min. (T15) after hypertonic saline (HS) infusion. ⋯ We can conclude that 7.5% saline in a dose of 1 ml/kg b.w. reduces brain bulk during craniotomy in patients with supratentorial mass lesions. In patients with a solid brain tumor this effect correlates negatively with a size of expanding mass. A slight changes in blood pressure and heart rate due to HS as well as moderate decrease in SK are within limits of clinical acceptance.
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Folia medica Cracoviensia · Jan 2001
Comparative Study Clinical Trial[Sevofluran in pediatric practice--personal experience].
Sevofluran a new inhalational anesthetic is a preferred anesthetic agent for induction and maintenance of pediatric anesthesia because of its rapid induction, recovery characteristics and acceptable cardiovascular profile--now also accessible in Poland. Sevofluran isn't an ideal anesthetic, and the issue of postoperative excitement, potential nephrotoxicity requires clarification. ⋯ We didn't use higher concentrations of sevoflurane than 5.5 Vol% and 3.5 Vol% for halothane. Sevoflurane patients has a greater incidence of emergence agitation.