Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2008
Randomized Controlled Trial[Role of paracetamol in a balanced postoperative analgesia scheme after thoracotomy].
The efficiency of paracetamol used in the balanced multimodal analgesia after thoracotomy still remains unclear. The prospective study covered 75 adult patients operated on the chest. The patients were randomized to 3 groups. ⋯ The high incidence of skin itch (20%) and urinary retention (8%) was observed in Group 3 (p < 0.017). No difference was found between the groups in the development of dyspepsia. The use of paracetamol in the postoperative multimodal analgesic therapy program after thoracotomy reduces the daily dose of epidurally administered ropivacaine and fentanyl with evident upgrade of analgesia quality, and the incidence of opioid-induced adverse reactions.
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Anesteziol Reanimatol · May 2008
Randomized Controlled Trial Comparative Study[Comparative analysis of the efficiency and safety of different types of neuroaxial blocks during total hip replacement].
The paper presents the results of a prospective randomized study in 108 elderly patients undergoing total hip replacement under different neuroaxial blocks. The characteristics of sensory and motor blocks, hemodynamic changes, and a need for infusion and sympathomimetic support under epidural, spinal, and unilateral spinal anesthesia were comparatively assessed.
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Anesteziol Reanimatol · Mar 2008
Randomized Controlled Trial Comparative Study[Tactics of infusion therapy in the acute period of intracranial hemorrhages].
The paper deals with the determination of infusion therapy tactics in critically ill patients with intracranial hemorrhages on the basis of invasive measurements of systemic hemodynamics. The routine hemodynamic parameters (blood and central venous pressures, heart rate) are noted to fail to assess the volemic status of the patients in full. Unlike the use of colloidal solutions, infusion therapy with physiological sodium chloride is not shown to correct systemic hemodynamics. It has been ascertained that in acute intracranial hemorrhages, infusion therapy with crystalloidal solutions leads to impaired pulmonary gas exchange and increased pulmonary extravascular fluid and the use of a combination of crystalloidal solutions and a colloidal agent in a 1:1 ratio can correct the volemic status of the patients and is not followed by lung dysfunctions.
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Anesteziol Reanimatol · Mar 2008
Randomized Controlled Trial[Effect of the combined hypertonic colloidal solution HyperHeas on hemodynamic and oxygen transport parameters, intracranial pressure, and cerebral oxygenation].
The paper gives the results of a clinical study of the effect of the new combined hypertonic colloidal and hypertonic solution HyperHaes (Frezenius-Cabi) on the parameters of systemic hemodynamics (invasive evaluation by means of a Swan-Ganz catheter), systemic oxygen transport, intracranial pressure (ICP) (lumbar spinal fluid pressure), and cerebral oximetry (INVOS 5100) in neurosurgical patients. The paradoxical effect was found as acute blood pressure lowering and elevated ICP on the beginning of solution infusion (the vasodilator effect of a distinctly hyperosmolar agent). In all other respects, HyperHaes is an ideal agent for volumetric compensation in neurosurgical patients.
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Anesteziol Reanimatol · Jan 2008
Randomized Controlled Trial[Efficiency of using ondansetron in the surgical treatment of post-burn cicatricial deformity in children with a history of postoperative nausea and vomiting].
The efficiency of using various formulations of the antiemetic ondansetron to prevent postoperative nausea and vomiting (PONV) in the surgical treatment of postburn scars and deformities in children with a family history of PONV was compared. The patients were randomized into 4 representative groups. ⋯ When the drug was used as syrup, PONV developed 2 times more frequently (PONV in 20% of the patients and 3 times more commonly when the drug was intravenously injected as jets during induction to anesthesia (PONV in 30% of the patients. When antiemetics were not given (a control group), the incidence was 7.5 times greater (75% of cases).