Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2001
Clinical Trial[Levels of troponin I, tropoinin T, isoenzyme MB creatine kinase and myoglobins in blood serum for perioperative diagnosis of myocardial infarction in patients after coronary artery bypass graft surgery with extracorporeal circulation].
We studied plasma levels of troponin I (cTnI), troponin T (cTnT), creatine kinase MB (CKMBmass) and myoglobin (MB) in patients undergoing coronary artery bypass surgery with extracorporeal circulation and cardioplegia. In group 1 (25 patients without perioperative myocardial infarction) plasma levels of all markers studied were elevated after operation. In group 2 (24 patients with perioperative myocardial infarction) plasma concentrations of all markers exceeded several times levels observed in patients without myocardial infarction with maximal value for MB at 12 hours after operation; for cTnI and CKMBmass at 16 hours after surgery and for cTnT at 32 hours after the end of operation. ROC curves show cut-off value for CKMBmass 20.3 ng/ml (sensitivity 79% and specificity 89%); for cTnI cut-off value was 0.8 ng/ml (sensitivity 80% and specificity 94%) for cTnT the cut-off value was 0.41 ng/ml (sensitivity 86% and specificity 88%) and for MB the cut-off value was 419 ng/ml (sensitivity 85% and specificity 70%). ⋯ All markers studied are reliable biochemical tests for perioperative myocardial infarction, however, the analysis of ROC curves suggested that cTnI and cTnT might be more useful for diagnosis of perioperative myocardial infarction after conventional coronary artery bypass surgery.
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Folia medica Cracoviensia · Jan 2001
Clinical Trial Controlled Clinical Trial[Mivacurium--use for complications of facial-cranial surgery--personal experience].
The aim of this study was to evaluate the effectiveness of mivacurium (Mivacron--GlaxoWellcome) during combined general anaesthesia in the operations on the facial cranium, after tracheal intubation performed using suxamethonium chloride (Chlorsuccillin--Polfa PL). We examined 20 patients, 17-65 years old, who were underwent operations due to facial and neck neoplasms or trauma. Patients were divided into two 10-person groups. ⋯ By 4 patient with heart failure prolongation of the activity time of Mivacurium was observed. The dose of 0.1 mg/kg, is efficient to maintain of the neuromuscular block on the stabile level. This allows the reduction of the total dose, and the decrease of the costs of the operation.
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Folia medica Cracoviensia · Jan 2001
Review[Anesthesiology consulting unit in perioperative medicine].
There is a demand, caused by increase of one-day surgery, surgery of high risk patients with coexisting diseases, and growing need for patient education, for such improvement of preoperative preparation, which will enable an optimalization in patient care. That became a special task of Preanesthetic Evaluation Clinic. The aim of the paper was to analyze activity of local Preanesthetic Evaluation Clinic in years 1993-2000. ⋯ As conclusions perspectives of further development of the Clinic were shown. Growing significance of an anesthetic nurse in perioperative patient preparation was foreseen. A demand for improving electronic patient records as well as use of new technologies was proven.
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Folia medica Cracoviensia · Jan 2001
[Principles of qualifying children for planned surgical procedures].
Children are prone to greater preoperative stress and more frequent accidents during anaesthesia. To reduce stress--a preoperative visit, information for child and parents, premedication and parental presence during induction of anaesthesia have all been successfully used. ⋯ There is less emphasis on minimal hemoglobin level of 10 g/dl, the physician assessment of circulatory status is preferred rather than stiff laboratory values. Less stress for children means also less problems during induction and recovery as well as less need for prolonged postoperative care.
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Folia medica Cracoviensia · Jan 2001
Review Comparative Study[Point systems for evaluating coma in patients with injuries of the central nervous system (CNS)].
Paper reviews various coma scales which are used to monitor consciousness after sustaining severe injuries of CNS. Glasgow Coma Scale, at present the most frequently used, was compared to recently developed scales, which are more useful for monitoring persistent comas, allows to evaluate discrete changes in patient's state more precisely and to predict the outcome. The necessity of evoked potentials' measurements, such as Trigeminal-Auditory Glasgow (Coma Scale) has been stressed.