Vestnik Rossiĭskoĭ akademii meditsinskikh nauk / Rossiĭskaia akademiia meditsinskikh nauk
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Vestn. Akad. Med. Nauk SSSR · Jan 1997
Review[Comparison of transesophageal and transthoracic echocardiography in cardiac surgical care].
This paper analyzes the results of 1093 transesophageal (TEE) and transthoracic echocardiographic (TTE) studies made in patients with various cardiovascular diseases in December 1989 to November 1996. The investigation was undertaken to define indications for TEE. ⋯ However, detection of thrombosis of the left ventricular apex remains to be priority in TTE. TEE was found to supplement TTE and considerably improves the diagnostic quality in cardiovascular diseases.
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Vestn. Akad. Med. Nauk SSSR · Jan 1997
Comparative Study[Laryngeal mask under total myoplegia and artificial pulmonary ventilation during laparoscopic cholecystectomies].
The problem of using a laryngeal mask (LM) under total myorelaxation and artificial pulmonary ventilation (APV) is still topical and unsolved. A hundred and forty six anesthesias for laparoscopic cholecystectomy by employing LM in 86 patients or endotracheal tube (ETT) in 60 were comparatively evaluated. Anesthesia included premedication (diazepam, dimedrol, atropine, the H2-blocking agent ranitidine), induction (ketamine, barbiturates and propofol in combination with diazepam and fentanyl; the NMBs pipecuronium bromide and succinylcholine), maintenance (N20:O2 = 2:1. ⋯ The hermetic sealing of joints was 95.6-98.5% in the LM group. Regurgitation was not found in 33 patients. LM NMB and APV may be successfully and safely used in clinical practice.
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Vestn. Akad. Med. Nauk SSSR · Jan 1997
[The use of continuous spinal anesthesia and combined spinal-epidural anesthesia in operations on lower extremity vessels].
Continuous spinal anesthesia with hyperbaric solution of 1% lidocaine and 0.375% bupivacaine and combined spinal-epidural anesthesia with solutions of 2% lidocaine and 0.375% bupivacaine by using in-run anesthesia ensure adequate anesthesia and persistent hemodynamic parameters during operations on lower extremity vessels. These procedures can be used in elderly high-risk patients.
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The evolution of central segmental blockades was studied in 133 patients by using epidural and spinal anesthesias. The efficiencies of 2% Ultracaine (Hoechst) and 2% Lidocaine (Egis) solutions used for epidural anesthesia and 5% Ultracaine (Hoechst) and 0.75% Bupivacaine (Astra) hyperbaric solutions were evaluated. Central segmental blockade induced by Ultracaine was found to be similar to Lidocaine and Bupivacaine in clinical parameters. ⋯ No differences were found in the magnitude of hemodynamic changes both with various anesthetics and different types of segmental blockades. The findings make it possible to regard Ultracaine as an drug that has some advantage over Lidocaine for prolonged epidural anesthesia and similar to the latter in pharmacological characteristics. Ultracaine may be regarded as alternative to Bupivacaine for spinal anesthesia.