Klinichna khirurhiia / Ministerstvo okhorony zdorov'ia Ukraïny, Naukove tovarystvo khirurhiv Ukraïny
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Randomized Controlled Trial
[Application of multimodal anesthesia/analgesia in complex of anesthesiological support of reconstructive operations, performed on the lower extremity arteries].
Anesthesiological support of 47 patients, while performing reconstructive operations on the lower extremities arteries in presence of the third level of operative risk (according to ASA), was analyzed; of them in 24 - a spinal anesthesia was applied, in 23 - a reduced spino-epidural anesthesia. Application of a spino-epidural anesthesia/analgesia with reduction of the dose of a spinal component and usage of analgesia instead of anesthesia secures lesser intraoperative oscillations of hemodynamic indices in comparison with such while performing spinal anesthesia, as well as better antinociceptive protection, is also characterized by small toxic impact on the patient, demands application of a sedative and the infusion therapy of lesser volume. While performing a potentially complex and durable reconstructive operations on the lower extremities arteries a wide application of the method depicted is recommended.
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In 1992 on symposium in Atlanta the general classification of an acute pancreatitis, adopted by world medical society for practical application, was proposed. Due to results of multiple investigations there were enhanced the data about an acute pancreatitis pathophysiology, the organs insufficiency, and improvement of the noninvasive and invasive methods of visualization and treatment, what caused necessity to revise the classification. ⋯ After first meeting the working group have directed the document project to 11 national and international associations of pancreatologists. In 2012 yr the definite conclusions, concerning consensus, were published.