Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2006
Review[Perioperative management of patients during general endoprosthethic operations on the knee joint (a review of literature)].
Arthrosis deformans of the knee joint (gonarthrosis) is a common disease accompanied by pain syndrome and disability. Medical treatment of the disease ensures only a temporary analgesic effect and fails to restore the range of motion in the legs. General endoprosthetic operations on the knee joint can significantly improve the results of treatment, alleviate pain, and restore the patients' working capacity. ⋯ Different approaches to adequate anesthesia are considered in both intra- and postoperative period. Numerous references lead to the conclusion that many widely used anesthetic procedures (general inhalational and intravenous anesthesia, high-conduction anesthesia, etc.) are incompletely adequate during a general endoprosthetic repair of the knee joint. A number of authors state that spinal or combined spinal epidural anesthesia is the most adequate methods of intra- and postoperative anesthesia at general endoprosthetic repair of the knee joint.
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This review permits assessment of whether sevoflurane complies with the requirements for an ideal inhalational anesthetic in neuroanesthesiology. It considers the pharmacokinetic characteristics of sevoflurane. The data of studies on animal and man are used to evaluate the effects of sevoflurane on the intracranial parameters of the central nervous system and on cerebral hemodynamics. Where possible, sevoflurane is compared with isoflurane that is currently regarded as the drug of choice in neuroanesthesia.