Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2011
Review[Monitoring of skin conductance in anesthesiology and intensive care].
The purpose of the study is to examine the efficacy and safety through the introduction of a local anesthetic wound irrigation catheter for continuous postoperative analgesia in newborns. The study was conducted during the postoperative period of 33 full-term newborns. In the study group (n = 15), analgesia was carried out through the wound catheter with infusion of local anesthetic, for the control group (n = 18) continuous intravenous infusion promedol was used. ⋯ The study showed that the use of wound catheter for continuous postoperative analgesia with local anesthetics provides effective level of analgesia in newborns, which is comparable with the introduction of opioid analgesics. There were no severe postoperative complications. The method of analgesia by administering a local anesthetic through the wound catheter can be recommended for postoperative analgesia in newborns, especially during major surgeries.
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A brief historical overview of the stages of development of outpatient surgery and anesthesiology is provided. It displays features of pre-selection and evaluation of patients for pediatric ambulatory surgery, the relation to the problems of preoperative fasting, anesthesia with concomitant diseases, the relative and absolute contraindications to outpatient surgeries in children. ⋯ Compares methods of induction and maintenance of anesthesia, the possible use of volatile and intravenous anesthetics in ambulatory surgery in children, the advantages and disadvantages of given methods, as well as options for their combination with regional blocks. Pays attention to the postoperative analgesia and control of postoperative nausea and vomiting, consider their side effects.
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Anesteziol Reanimatol · Jan 2011
Review[Controlled mechanical lung ventilation with guaranteed volume in newborns].
Mechanical ventilation with guaranteed volumes combines advantages of time-cyclic ventilation with limitation of pressure and constant flow, with volume control ventilation. This symbiosis allows to choose the optimal, stable breathing volume of the newborn, while maintaining pressure control. The review presents the principles of work, the main advantages and limitations of ventilation systems with the guaranteed volumes, as well as results and analysis of studies.
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Myoplegia during laparascopic surgeries in children].
The purpose of the study is to optimize the general anesthesia for laparoscopic surgery in children with rokuronium bromide. We investigated the effect of rokuronium on children from 3 to 17 years of age who underwent laparoscopic surgery for up to one hour in the department of anesthesiology and resuscitation of Tushino City Pediatric Hospital. The study included 31 children rated ASA I-II. ⋯ For the most rapid and comfortable tracheal intubation the optimal combination is rocuronium in a dose of 0.6 mg/kg (2 * ED90) with sevoflurane (52 + 7.7 sec). This method can be applied to case of emergency need for endotracheal intubation. Regardless of the anesthetic, the recovery time of the neuromuscular conduction changes inconsiderably reaching the secure level of TOF? 70% at laparoscopic operations for up to one hour, after which it is possible extubate the patient, which suggests t the predictability of rocuronium.
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Treatment and diagnostic measures, including anesthesia during catastrophes and natural disasters are a world known problem. The paper presents the experience of anesthetic care provision during specialized surgical care to the victim children of the earthquake in Haiti. ⋯ The peculiarities of anesthesia during the treatment of wound process depending on the stage of surgery are brought into view. During the preparatory phase the optimal type of anesthesia is inhalation and intravenous anesthesia, whereas for the defect closure (main stage) all types of anesthesia, including balanced endotracheal and combined anesthesia were used.