Khirurgii͡a
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Comparative Study Clinical Trial Controlled Clinical Trial
[Ketamine at low doses + etomidate or diazepam--a comparative clinical study of anesthesia in urology].
Eighty urological patients, divided in two equal groups, are anesthesized using two anaesthetic combinations: small dose kaliposol + etomidate, or diazepam. The obtained results point to a stability of the arterial pressure and pulse rate and prompt recovery, rendering the kalipsol-etomidate combination an alternative to the kalipsol-diazepam one which is well affirmed in urological practice.
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Case Reports
[Intraoperative anaphylactic shock following the percutaneous puncture of a hepatic echinococcal cyst].
This is a report on a case of severe intraoperative anaphylactic shock, developing within several hours of percutaneous puncture of a liver hydatid cyst, performed under echographic control, necessitating recovery from the shock state and discontinuation of the operative intervention. Inferences are reached regarding the most adequate treatment tactics to be adopted in handling such cases. Percutaneous puncture is discarded as a therapeutic approach because of the great risk of anaphylaxis with eventual lethal outcome, and the likelihood of severe abdominal echinococcosis development at a later period.
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In a series of fifty-two patients undergoing abdominal surgery the listed below agents for postoperative analgesia are used: moradol (M), dipidolor (D), droperidol--DNBP, fentanyl (F). The control group is given analgin. During the first six hours, M and D show optimal effect in terms of postoperative pain syndrome relief, without suppression of the hemodynamics and respiration.
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For a period of 13 months (from April 1993 till May 1994) 14 patients (5 men and 9 women) have been examined intraoperatively with transesophageal echocardiography. Nine of the patients were with mitral valve lesion, three of them with mitral valve lesion, complicated with tricuspidalisation, one patient with mitral-aortic valve lesion and high grade tricuspid regurgitation and one patient with aortic valve disease. The purpose of the intraoperative transesophageal echocardiography was to surgical valve repair by measuring the residual stenosis and regurgitation. ⋯ The results of both echocardiographic examinations, correlate to a great extent. The existing difference in assessment of the degree of valvular lesions is due to the specific intraoperative haemodynamic situation. Intraoperative transesophageal echocardiography is a valuable method in assessment of surgical valve repair.
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Combined spinal and epidural analgesia is a new concept in the field of regional anesthesia. It combines the positive qualities of spinal and epidural analgesia, and is performed by the "needle-in-needle" technique, described in the paper. This type of analgesia is practically implemented in the Clinical Center of Urology over the past few months, and shows encouraging results. ⋯ The block induced is with 4-hour duration, and lends itself to prolongation through an epidural catheter. This renders the method variable and suited for postoperative analgesia too. The Espokan set technical devices used make puncture of the spinal-epidural space readily practicable.