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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Randomized Controlled Trial
[Diagnosis and correction of hemostasis disorder during surgeries for bile duct diseases].
The aim of the study was to reduce the frequency of hemorrhagic complications in the surgical treatment of patients for diseases of bile ducts. Hemostatic state before, immediately after and on the following day after the operation was controlled by the data of frequency piezoelectric thromboelastography. It is established, that the application of tranexamic acid to promote incidence of hemorrhagic complications are reduced by 38.65%.
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Randomized Controlled Trial
[Character and speed of recovery of psychophysiological functions after application of various kinds of anesthesia in conditions of a "one-day" stationary].
The frequency of operative interventions, performed according to the "one-day" stationary technology is raising every day. The patients are choosed in accordance with conventional methods, while somatic state of a patient and the further operation volume playing the leading role. ⋯ There was proved, that apart of general anaesthesy scheme applied, in all the patients the cognitive functions defect was noted in postoperative period. These functions are restored most quickly in application of propofol in the scheme and most slower in mononarcosis with ketamin.
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Randomized Controlled Trial
[Anesthesia based on ketamin during performance of a high-risk operations: advantages and misadvantages].
The impact of a general anesthesia scheme, using ketamin, and of various intensive therapy schemes, on hemostasis indices was studied in patients, suffering an acute hemorrhage of a high operative risk. The silent interrelationship between these indices and the common clinical indices dynamics was established.