Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2013
Clinical Trial[Prevention of cognitive disorders in postoperative period after carotid endarterectomy].
238 patients with atherosclerosis of carotid arteries after reconstructive operations under different types of anesthesia were enrolled in the study. Neuropsychological survey with Montreal cognitive assessment scale, frontal assessment battery and clock drawing test was performed in dynamics. Minimal cognitive dysfunction was mentioned in patients with symptomatic and asymptomatic stenosis after combined anesthesia with regional anesthesia. ⋯ After inhalation anesthesia it was more severe. Prevention of postoperative cognitive dysfunction with ceraxon was clinically effective. This therapy can facilitate mental functions recovery and improve quality of life.
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Anesteziol Reanimatol · Jul 2013
Clinical Trial[Patient positioning on the operating table in neurosurgery: sitting or lying].
Efficacy and safety of microvascular decompression of trigeminal nerve depending on the position on the operating table were assessed in 200 neurosurgical patients in retrospective observational study It was shown that efficacy doesn't depend on positioning. Lying position eliminates probability of such complications as postural hypotension, hypotension during surgery, tension pneumocephalus and peripheral nerves injury. ⋯ It is also decreases risk of corneal reflex reduction by 3 times, hyperpathia by 2 times and paresthesias by 5 times, but increases probability of postoperative hyperesthesia by 4 times. Microvascular decompression of trigeminal nerve in lying position is safer than similar operation in sitting position.
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Anesteziol Reanimatol · Jul 2013
[Intracranial pressure plateau waves in patients with severe traumatic brain injury].
The goal of the study was to assess frequency of plato waves, their influence on outcomes and define factors leading to plato waves. Ninety eight patients with severe traumatic brain injury (TBI) were included. Blood pressure (BP), intracranial pressure (ICP), cerebral perfusion pressure (CPP) and pressure reactivity index (Prx) were registered. ⋯ CPP did not differ in groups, because CPP was strictly controlled. Patients of the group I had preserved autoregulation and less severe trauma (predominance of closed trauma and Marshall I, II type of brain damage). Plato waves did not predict bad outcomes.
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Anesteziol Reanimatol · Jul 2013
[Morphological changes in the lumbar dorsal root ganglion of the domestic porcine after pulsed radiofrequency stimulation].
Pulsed radiofrequency (PRF) is a percutaneous minimal invasive procedure that can be used when conservative pain therapy methods have been ineffective. The effectiveness of PRF was demonstrated in various good quality randomized control studies, but mechanisms of action are still unclear. The aim of our study is to analyse the histological effects of PRF on the domestic porcine dorsal root ganglion (DRG), and evaluate the expression of biomarkers in gangliocytes. 3 domestic porcines were investigated. ⋯ PRF in spinal gangliocytes of lumbar region increases neural tissue cytoskeleton factors like NF and GFAP suggesting about active regeneration processes into the cells 1 month after the procedure. Spinal gangliocytes one month after PRF treatment notably increases Hsp-70 expression suggesting about activation of cellular activity and inhibitory role reducing of oxidative stress. Similar number of apoptotic cells in spinal ganglia of lumbar region after PRF and control side suggests about inhibitory role of PRF on programmed cell death and stimulation of cell survival.
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Anesteziol Reanimatol · Jul 2013
Clinical Trial[Citicoline as component of the therapy of postoperative delirium in neurosurgical patients].
Delirium is a clinical sign of acute cerebral dysfunction. It is characterized by consciousness alterations with attention impairment and mentally disorganization. Frequency of delirium is 40-80% in general intensive care and more in patients in neurointensive care unit. ⋯ These results show that citicoline didn't influence on duration of mechanical ventilation and length of stay in ICU. Outcomes were similar in both groups, but frequency of full functional state recovery in citicoline group was significantly higher: 5 (41.7%) to 2 (25%) in control group (p < 0.05). We consider that citicoline therapy is safe for patients with tumors of chiasm-sellar area and lead to increasing of frequency of full functional state recovery.