Vestnik Rossiĭskoĭ akademii meditsinskikh nauk / Rossiĭskaia akademiia meditsinskikh nauk
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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.
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Vestn. Akad. Med. Nauk SSSR · Jan 1996
Review[Age, sex, genetic and exogenous factors as determinants of plasma protein binding of drugs].
The data on relations of individual variations in the plasma protein binding of drugs to age, sex, genetic monitoring, and some environmental factors among which food and lifestyle (smoking, alcohol and coffee consumption, exercise, etc.) are of much importance. Individual variability in the plasma protein binding of drugs may be of great significance for pharmacokinetics and pharmacodynamics.
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Vestn. Akad. Med. Nauk SSSR · Jan 1996
[The health of the population of the Russian Federation: the problems and the outlook].
The paper provides evidence that the general assessment of Russia's population health suggests its poor state which can lead to deterioration of the quality of the population and to its limited creative participation in improving the socioeconomic situation in the country. Exigency of the nation's health promotion requires that an elaborate and sane, responsible state policy should be worked out in health protection with the purpose of legal regulation of the organizational, structural, financial, and economic principles of the functioning of the public health care system at the federal, regional, and local levels. Russia needs the legal reformation of the public health system, by preserving its beneficial characteristics and by revealing the mechanisms of its adaptation to the changing legal and socioeconomic conditions.