Anesteziologiia i reanimatologiia
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So far, the ongoing debate about the appropriateness of combining drugs with different mechanisms of analgesic action for optimal antinociceptive protection. The review deals with the theoretical calculations arguing with the physiological rationality for the inclusion of central α2-agonists in the scheme of modern multimodal analgesia. We have presented data from recent reviews regarding the efficacy and safety of intraoperative application of dexmedetomidine as a one of the latest drugs in this class.
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Anesteziol Reanimatol · Mar 2015
Randomized Controlled Trial[COMPARISON OF THE EFFECTIVENESS OF ILIOINGUINAL-ILIOHYPOGASTRIC BLOCKADE AND TRANSVERSUS ABDOMINIS PLANE BLOCK FOR ANALGESIA AFTER CESAREAN SECTION].
In this prospective randomized study we compared the analgesic efficacy of the ilioinguinal-iliohypogastric nerves block and transversus abdominis plane block for analgesia after caesarean delivery performed by suprapubic laparotomy. The study includes 164 healthy women with ASA status I-II class, undergoing elective surgery under spinal anaesthesia. During the first postoperative hour patients in the "block's" groups received ultrasound-guided blocks of the anterior abdominal wall with ropivacaine 100 mg both. ⋯ Patients were monitored for visual analogue scale (VAS) scores at rest and during movement (at 3, 6, 9, 12 and 24 hours after surgery), concentration of the cortisol and glucose were measured, and consumption of the tramadol and its adverse effects were controlled. We concluded that both blocks improve postoperative analgesia after caesarean delivery. The Ilioinguinal-iliohypogastric block showed greater efficacy than the transversus abdominis plane block.
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Anesteziol Reanimatol · Mar 2015
Multicenter Study Observational Study[RUSSIAN NATIONAL EPIDEMIOLOGICAL STUDY "RUVENT": THE USE OF ARTIFICIAL LUNG VENTILATION IN THE INTENSIVE THERAPY IN CHILDREN].
Purpose of this part of the "RuVent" research is to study the real use of the various modes and parameters of prolonged respiratory support in children in Russia. ⋯ The results of the Russian national epidemiological study of the use of mechanical ventilation in the Intensive care unit ("RuVent") showed comparable data with real international clinical practice. The researchers noted significant differences during prolonged mechanical ventilation in children compared with adult patients.
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Anesteziol Reanimatol · Mar 2015
Clinical Trial[AIRWAY MANAGEMENT IN CHILDREN DURING RESECTION OF THE TONSILS].
We conducted a comparative evaluation of anesthesia used during tracheal intubation with and without the application of muscle relaxants in cases of adenotonsillectomy in children. Intubation parameters were evaluated according to Cormack-Lehane scale; the presence of cough reflex, limb movement, laryngospasm and desaturation during intubation was also taken into account. The presence of cough, husky voice, and complaints of pain in the throat were recorded in the monitoring report after extubation. We used the MOPS scale to evaluate postoperative pain and discomfort in children. ⋯ Thus, the method of tracheal intubation without the use of muscle relaxants can be used for adenotonsillectomy in children.
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Delirium in the intensive care unit is a frequent and serious complication, significantly worsens the prognosis of the underlying disease. Diagnoses that assign patients with delirium include an acute encephalopathy toxic encephalopathy, resuscitation psychosis, and this is an incomplete list. Thus, delirium is apparently not a separate disease, is more likely that this is a symptom of central nervous system polyethiological inherently. ⋯ There are no specific methods for the prevention of delirium, but the observance of some simple rules can prevent its development. We should treat the disease, which has led to the appearance of delirium symptoms. For relief discussed the state recommended that a mild sedative non-benzodiazepine drugs (dexmedetomidine better) with a daily assessment of the level of consciousness.