Anesteziologiia i reanimatologiia
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The treatment of chronic non-malignant pain is actual medical problem. Varies clinical symptoms and absents of treatment standards make those problems very difficult to manage. We presented basic concept of chronic pain and multidisciplinary stages of treatment.
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Anesteziol Reanimatol · Nov 2011
Comparative Study[Role of regional anesthesia in prevention of postoperative respiratory dysfunction].
The aim of the study is to evaluate postoperative respiratory dysfunction in abdominal surgery based on level of invention and type anesthesia and postoperative pain management. ⋯ extended-release epidural anesthesia was beneficial effects on postoperative respiratory dysfunction and reduces rate of pneumonia postoperatively.
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Anesteziol Reanimatol · Nov 2011
Randomized Controlled Trial Comparative Study[Combined inhalation and epidural anesthesia, during aortocoronary bypass surgery on beating heart].
Aim of study is to compare efficiency and safety of different methods of combined inhalational and epidural anesthesia during aortocoronary bypass surgery on beating heart. ⋯ 40 patients suffering from coronary heart disease were included in randomized study. Two methods of combined inhalational and epidural anesthesia were compared. The first group of 22 patients were administrated extended-release epidural anesthesia with Ropivacaine 0.3% in upper thoracic region and Sevoflurane as a volatile agent. Second group of 18 patients were administrated Isoflurane and epidural anesthesia. Monitoring: (Harvard standard of monitoring), BIS, invasive monitoring of hemodynamic, the dose of anesthetic gas, internal medical audit. Result of the study showed that all patient had same duration of surgery, level of unconsciousness (BIS 40-45%) dose of valiant anesthetic agents less than 1 MAC, same dose of Ropivacaine, minimal dose of opioids, quantity and quality of intravenous infusion therapy and same amount of vasopressors. It was discovered that Sevoflurane had influenced hemodynamic less than Isoflurane. The results of internal retrospective medical study showed safety of both methods of anesthesia. Sevoflurane allowed fast postoperative recovery on 1,74 times ,early extubation in theater on 1,64 times. Both methods of combined anesthesia epidural and inhalational presented good results and can be performed in coronary bypass surgery but for fast-track surgery and anesthesia use of Sevoflurane is better.
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Anesteziol Reanimatol · Nov 2011
Comparative Study Controlled Clinical Trial[Intravenous and transfusion therapy and acid-base balance during liver transplantation].
The aim of the study is to investigate the influence of intravenous fluid therapy and transfusion therapy with different amount of fresh frozen plasma and crystalloids. ⋯ IVT with equal amount of FFP and crystalloids is optimal for liver transplantation surgery because it prevents development of metabolic acidosis wich appears due to intravenous infusion large dose of crystalloids on the other had it prevent metabolic alkalosis at the end of the surgery because of considerable amount of FFP.
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Anesteziol Reanimatol · Nov 2011
Case Reports[Effective epidural anesthesia for cesarean section in parturient woman with type I mucopolysaccharidosis (Hurler's syndrome)].
Mucopolysaccharidosis is genetically determined disease caused by the deficiency of one of the lysosomal enzymes involved in the glycosaminoglycan (GAG) breakdown pathway. This metabolic block leads to the accumulation of GAG in various organs and tissues and affects nerve system, eyes, internal organs and musculoskeletal system. The reviewer of various articles on pubmed showed only one article about epidural anesthesia in patient with type I mucopolysaccharidosis. Our observation allows to consider that epidural anesthesia with ropivacaine is possible and safe in patients with type I mucopolysaccharidosis.