Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2015
Randomized Controlled Trial[PROTEIN KINASE C EXPRESSION FOLLOWING REMOTE ISCHEMIC PRECONDITIONING IN CARDIAC SURGERY].
To evaluate cardioprotective effects of remote ischemic preconditioning (RIPC) in cardiac surgery patients undergoing aortic valve replacement depending on the type of anesthesia and investigate the level of myocardial protein kinase C epsilon (PKC-ε) expression after RIPC. ⋯ RIPC was only effective when it was applied during sevofiurane anesthesia. This was confirmed by PKC-ε expression increase and lower value of cTnI. There were no evidence of preconditioning and cardioprotection when MPG was initiated during propofol anesthesia.
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Anesteziol Reanimatol · Nov 2015
Review[EFFECTS OF XENON ANESTHESIA ON HEMODYNAMICS: WHAT DO WE KNOW UNTIL 2015? (REVIEW)].
Xenon is known as an anesthetic in many ways closer to the ideal. In recent years, despite a number of objective reasons limiting its widespread use, the search continues for understanding how xenon influences on central hemodynamic parameters and regional blood flow. ⋯ Foreign researchers in animal experiments notice vasoconstrictor properties of Xe with increased vascular resistance in the systemic and pulmonary circulation. The place of Xe as an anesthetic in the anesthetist's arsenal yet to be seen.
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Anesteziol Reanimatol · Nov 2015
Review[VOLEMIC STATUS AND THE PHASIC APPROACH TO THE TREATMENT OF CRITICAL STATES--NEW OPPORTUNITES AND PROSPECTS].
Current guidelines suggest that an early and aggressive fluid therapy is the best rescue approach to restore and preserve cardiac index, organ function and decrease the risk of multiple organ failure in shock of various origin. However, escala- tion of fluid resuscitation is a double-edged sword often associated with reperfusion, glicocalyx injury, capillary leakage, delayed weight gain and heperhydration. ⋯ The type and volume of the fluid should be thoroughly selected in accordance with the phase of shock, risk of impending organ dysfunction and individual co-morbidity. The phasic approach, along with individualized early and delayed goal-directed protocols might fasten the resolution of organ dysfunction, reduce the duration of shock and mechanical ventilation and improve the outcomes.
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Anesteziol Reanimatol · Nov 2015
[STAGES OF OPIOID THERAPY OF CHRONIC PAIN IN RUSSIA: ANCIENT AND COMING].
There is history of the introduction and development of systemic and invasive opioid treatment of chronic cancer pain in Russia presented by the authors--experts with experience in thisfield over 30 years. The earliest researchers are no more among us, but their memory is still alive in the publications of the early 1980's. Along with the analysis of accumulated by Russian specialists positive clinical experience of opioids using, authors discuss main problems of organization and availability of adequate opioid therapy of chronic pain in Russia. Ways of further development ofpalliative care and pain management in oncology is discussed as well as.
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Anesteziol Reanimatol · Nov 2015
[OPIOID-FREE ANESTHESIA, ANALGESIA AND SEDATION IN SURGERY OF HEAD AND NECK TUMOR].
62 adult patients had highly traumatic cancer head and neck surgery under multimodal non-opioid general anesthesia consisted of dexmedetomidine, lidocane, nefopam and sevoflurane. 18 patients had been intubatedwith fiber optic bronchoscope because of II-IV grade trismus. 10 patients with laryngeal stenosis had been tracheotomizedfor intubation. All these 28 patients had been sedated with dexmedetomidine, lidocane and small doses (10-20 mg) ketamine additionally to local anesthesia. All these patients maintained consciousness and breathed spontaneously. ⋯ On the day. 3 analgesia proceeded with nefopam and tenoxycam i.m. The quality of analgesia was good, with no complications. Only 3 patients had one promedol (trimeperidine) or tramadol iniection at the start-up of this new method of analgesia.