Anesteziologiia i reanimatologiia
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The article deals with a study of duration of physiological labors in women with diabetes mellitus. ⋯ Analgesia with promedol and paracetamol is a preferable method in case of presence of epidural analgesia contraindications.
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Anesteziol Reanimatol · Jan 2015
Observational Study[Clinical aspects of the service of acute postoperative pain treatment].
To analyze work results of the service of acute postoperative pain treatment in the orthopedic hospital. DISIGN: Single-center retrospective observational cohort study. ⋯ The work of the service of acute postoperative pain treatment in the orthopedic hospital, the use of multimodal treatment protocols and mandatory clinical monitoring provide proper control of postoperative pain, patient satisfaction, and allow to accelerate early recovery and reduce the time of postoperative hospital stay after total replacement of large joints.
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Anesteziol Reanimatol · Jan 2015
[Background and perspectives of opioid analgesics for the treatment of chronic pain in cancer patients in Russia].
The article deals with an analysis of availability of narcotic analgesics for the patients in the Russian Federation. The analysis was based on datafrom official sources on the scopes of opioids delivery in different regions of the Russian Federation and showed an extremely limited availability of narcotic analgesics for the patients in the Russian Federation. We found that availability of narcotic analgesics in Russia is hundreds times lower than the same indexes in European countries with various level of economic activity and in the USA. ⋯ Drugs from this list can be effectually used for the chronic pain therapy in oncology. The most advanced drugs that are soon will be produced are also named. The article describes high priority measures that have already been done to improve current situation and measures to be executed in the future.
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Anesteziol Reanimatol · Jan 2015
[Optimization of infusion therapy in patients with ovarian cancer].
We investigated the clinical observations and the results of a comprehensive survey of 70 patients with ovarian cancer stage III-IV aged 30 to 70 years with the presence of endotoxemia. Integral assessment of prognosis and severity of the condition was performed according to SAPS II and SOFA. Infusion program included a preliminary correction of hypovolemia prior to surgery on the operating table in equal parts, HES and balanced crystalloid solutions, with in- creased infusion of 15% of blood volume based on the method of anesthesia. ⋯ Analysis of the results revealed that premorbid background in patients with ovarian cancer stage III-IV was characterized by hypovolemia, phenomena hepatopathy, and endotoxemia, and mixed forms of hypoxia of varying severity. Differentiated approach to the choice of pathogenesis-based perioperative infusion according to premorbid condition, anesthesia and blood loss contributed to the elimination of hypovolemia, favored efficient oxygen delivery and consumption, the ade- quacy of tissue oxygenation. Remaxol inclusion in the perioperative infusion programs in patients with ovarian cancer enhanced their clinical efficiency, reduced cytolytic and cholestatic syndromes, recovered of protein and synthetic liver function, reduced the appearance of mixedforms of hypoxia and endogenous intoxication.
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Anesteziol Reanimatol · Jan 2015
Randomized Controlled Trial[Comparison of sedation with dexmedetomidine and haloperidol in patients with delirium after femoral neck fractures].
Delirium seriously complicates the recovery period after surgery, injury and increases mortality in elderly patients with femoral fractures. ⋯ We examined 80 geriatric patients admitted to the Institute of Traumatology and Orthopedics in Astana in the period from September 2012 to June 2014. We evaluated the efficacy of dexmedetomidine and haloperidol sedation according to RASS, communication ability and level of tolerance of procedures. The effect of dexmedetomidine was better and was expressed 30.3% decreasing of the duration of delirium in comparison with haloperidol (p < 0.05). Overall assessment of the ability of patients to the interaction, cooperation and tolerance of procedures evaluated by nurses, was higher in the dexmedetomidine group compared with haloperidol, as well as evaluating the effectiveness of individual communication and cooperation (8.3 ± 2.3 points vs 4.5 ± 1.9 points, p < 0.05). Despite the development of bradycardia in a small number of patients, as well as headaches and nausea after stopping the infusion, dexmedetomidine provided a more controlled and safe sedation compared with haloperidol.