Anesteziologiia i reanimatologiia
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The article deals with an analysis of the publications devoted of local anaesthetics' systemic toxicity (LAST) due to regional anaesthesia and symptoms of this potentially lethal complication. The review discusses features of systemic absorption and forms of local anaesthetics' neurotoxicity and cardiotoxicity in children, including newborns, differences of clinical signs of the LAST in adults and children and dosage of racemic bupivacaine. Moreover, the article deals with a modified treatment protocol for LAST and a method of lipid resuscitation with 20% lipid emulsion in the form of Intralipid. In conclusion the article discusses recommendations for LAST prophylaxis and scenarios during cardiopulmonary and cerebral resuscitation.
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Anesteziol Reanimatol · Sep 2014
Multicenter Study["Evidance"--Russian national epidemiological study].
The article deals with results of epidemiological study of 2516 ICU patients received prophylaxis of a deep vein thrombosis (DVT) and venous thromboembolic complications (VTEC). ⋯ An analysis of drugs for prophylaxis of DVT and VTEC which were used in patients with ARF showed that the prophylaxis was performed without a taking in account a significance of such complication.
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Anesteziol Reanimatol · Sep 2014
[Ultrasound guided catheterization of thoracic paravertebral space].
Prolonged thoracic paravertebral block is a complex technique of regional anesthesia. For a long time paravertebral blocks were conducted under stimulation. ⋯ Successful and safe block under ultrasound guidance requires: identification and visualization of paravertebral space; operator's skill in needle visualization in real time; experience in estimating the distribution of local anesthetic in PVS. Sonographic navigation makes PVS much easier to find and optimizes introduction of a local anesthetic thus providing adequate long-term pain relief without complications.
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To develop effective and safe measures of postoperative multimodal analgesia (optimizing the use of narcotic analgesics) in surgical treatment of hematological patients with thrombocytopenia. ⋯ Nefopam and paracetamol may be used in patients with thrombocytopenia, as do not affect the hemostasis and platelet count. Application of postoperative analgesia scheme paracetamol + trimeperidin in patients receiving corticosteroids provides the maximum reduction of pain with the least consumption of narcotic analgesics.
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Anesteziol Reanimatol · Sep 2014
Randomized Controlled Trial[Neutrophil gelatinase-associated lipocalin (u-NGAL) in the assessment of renal function in patients after kidney allotransplantation].
Early dysfunction of transplanted kidney is a serious complication that can lead to the premature loss of transplant. Ischemic and reperfusion injury of donor kidney leads to the disturbance of the function of the graft, which is a form of post-transplantation acute kidney injury that causes the relevance of search of early markers for diagnosis. ⋯ Due to prolonged period of ischemia in kidney transplantation from a donor with established brain death the level of u-NGAL in these patients was significantly higher than in the kidneys transplantation from living human-related donor. In patients after transplantation dynamics of u-NGAL allows to identify patients with delayed graft function recovery and the need for renal replacement therapy already in the early postoperative period.