PAIN, ANAESTHESIA & INTENSIVE CARE最新文献

{"title":"PAIN INTENSITY OF PATIENTS DURING REHABILITATION AFTER MINE BLAST WOUNDS","authors":"V. Horoshko, I. Kuchyn","doi":"10.25284/2519-2078.1(102).2023.278309","DOIUrl":"https://doi.org/10.25284/2519-2078.1(102).2023.278309","url":null,"abstract":"In 83.3 % of cases, patients who received mine blast wounds suffer from chronic pain. Such injuries are characterized by significant damage. Data on the treatment of pain during rehabilitation are presented by several clinical cases. Therefore, a broader coverage of this issue will be of some importance for the perspective of further research in this direction. \u0000The goal of the work. To investigate the results of pain treatment in patients after mine blast wounds at the rehabilitation stage. \u0000Methods. The treatment of 280 patients with mine blast wounds during rehabilitation was analyzed. The intensity of pain was diagnosed using a visual analog scale. Statistical methods: Shapiro-Wilk, Mann-Whitney, Friedman, chi-square, Bonferroni corrections, absolute frequency of the symptom and relative frequency (%). When analyzing the data in all cases, the critical significance level was 0.05. \u0000Results. Patients after mine blast wounds, both at the time of discharge from inpatient treatment and during rehabilitation, still experienced pain intensity of 2 points, which in the future transformed into chronic pain. After 1, 3 and 6 months after treatment, it was found that the intensity of pain in groups 1 and 2 did not differ statistically (р=0.488, р=0.876, р=0.165, respectively), but after 12 months – statistically differed (р=0.035) and in group 2 were higher than in group 1. \u0000Conclusions. Based on the obtained data, it can be concluded that during discharge from inpatient treatment, rehabilitation and within 12 months after treatment, the patients felt pain, albeit weak. The lack of further effective treatment can cause a whole cascade of negative consequences.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128603316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OPTIMIZATION OF HYPERBARIC ANESTHETIC DOSAGE FOR UNILATERAL SPINAL ANESTHESIA IN ORTHOPEDIC AND TRAUMA OPERATIONS","authors":"I. Kozlovska, Oleksandr I Datsyuk","doi":"10.25284/2519-2078.1(102).2023.278308","DOIUrl":"https://doi.org/10.25284/2519-2078.1(102).2023.278308","url":null,"abstract":"Topicality. Using generally accepted methods of calculating doses of local anesthetic during spinal anesthesia, the efficiency and safety of anesthesia are not always sufficient. \u0000The aim of our study was to determine the optimal dose of local anesthetic according to the height of the patient gradation method for unilateral and bilateral spinal anesthesia during orthopedic and traumatological operations on the lower extremities. Determine the advantages and disadvantages of both methods of analgesia. \u0000Materials and methods: Our study is based on an examination of 52 patients of I-II degrees of surgical risk according to ASA, divided into two groups. The first group (control) included 25 patients who underwent bilateral spinal anesthesia, the second group included 27 patients who underwent unilateral spinal anesthesia during orthopedic and traumatological operations on the lower extremities. Spinal anesthesia was performed with a hyperbaric solution of 0.5% bupivacaine, with the anesthetic dosing algorithm developed by us. \u0000Results: When evaluating the effectiveness of the performed spinal anesthesia, the duration of sensory and motor blocks and the level of development of sensory blockade by dermatomes in both study groups were determined. In the 1st group, the sensory block was 252.2±74.32 min., the motor block was 198.2±59 min. In the II group, the sensory block was 189.25±34.27 min., the motor block was 154.07±28.59 min. When determining the frequency of cardiovascular complications, dynamics of indicators in mean arterial pressure (MAP) and heart rate (HR) were determined before surgery, after 5 min., 30 min., 1 h., 2 h., 3 h., 5 h., 7 h., 9 h. It was found that the decrease in MAP and heart rate prevailed in the first group during the study. The volume of crystalloid infusion in the first research group was 2042±663.9 ml, and in the second group – 1666.66±635.49 ml. Laboratory diagnostic methods were used in order to determine dynamics of indicators in the basic metabolism and hormonal background during the occurrence of pain syndrome in patients and the effect of the dose of local anesthetic on the speed and level of changes in these parameters. For this purpose, changes in blood glucose, lactate and blood cortisol were determined before surgery, 3 hours, 6 hours and 9 hours of anesthesia course. \u0000Conclusions: 1. Gradational dosing of local anesthetic for unilateral and bilateral spinal anesthesia according to height ensures the necessary effectiveness of analgesia. 2. Reducing the dose of anesthetic during unilateral spinal anesthesia increases the safety of anesthesia and causes less side effects. 3. The duration and level of sensory blockade of unilateral spinal anesthesia is significantly reduced when using a reduced dose of local anesthetic in comparison with bilateral.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116229616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PATIENT MONITORING DURING PROCEDURAL SEDATION: ARE THE MODERN STANDARDS IMPLEMENTED IN UKRAINE?","authors":"K. Bielka, M. Frank, I. Kuchyn, M. Didenko, N. Semenko","doi":"10.25284/2519-2078.1(102).2023.278303","DOIUrl":"https://doi.org/10.25284/2519-2078.1(102).2023.278303","url":null,"abstract":"The purpose of the study was to review modern recommendations regarding the monitoring of patients during procedural sedation and analgesia as well as to assess its conformity to the modern standards in Ukraine. \u0000Materials and methods. Recommendations from European, American, British and Australian organizations which cover the topic of procedural sedation and analgesia or levels of anesthesia that conform to the procedural sedation corresponding to ASA, the standard monitoring during anesthesia, and were published between 2003 and 2023 have been reviewed. From 17 till 20th of March a survey has been conducted. Throughout the survey, participants have anonymously filled a questionnaire via Google-Form. The link to the questionnaire was shared by the Department of Anesthesiology and Intensive Care of the Institute of Postgraduate Education of Bogomolets National University with support provided by Association of Anesthesiologists of Ukraine through social networks such as Facebook and Instagram on the official pages of the Department of Surgery, Anesthesiology, and Intensive Care of the Institute of Postgraduate Education of the Bogomolets National Medical University. \u0000Results. A total of 284 doctors took part in the survey. Among them 280 (98.5 %) have been working in Ukraine during the survey, 4 (1.5 %) have been excluded from the analysis. Pulse oximetry was regularly used by 278 (99.2 %), automatic arterial pressure measurement by 222 (79.4 %), manual measurement of arterial pressure by 35 (12.5 %), ECG-monitoring by 95 (34.2 %), capnography by 35 (12.5 %), thermometry by 10 (3.5 %), electroencephalography by 4 (1.6 %) of the doctors (Fig. 3). 36 (12.8 %) of the respondents have informed about the absence of technical means to conduct ECG-monitoring, 172 (62.5 %) have conducted it in a selective manner. The results are presented in form of descriptive statistics and diagrams. \u0000Conclusion. Procedural sedation is a safe method provided that modern safety standards are systematically followed. Full monitoring is a prerequisite for timely response to critical events and mitigation of their consequences. Reporting problems of any degree of criticality that occurred during sedation helps to optimize local practices and has a positive effect on the quality of medical care. Introduction of routine capnography, electrocardiography and thermometry are prioritized goals when it comes to increasing the quality of monitoring in Ukraine.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"516 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123064870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHANGES IN HEMODYNAMICS INDICATORS IN THE PERIOPERATIVE PERIOD IN PATIENTS IN THORACIC SURGERY","authors":"H. Poniatovska, S. Dubrov","doi":"10.25284/2519-2078.4(101).2022.275114","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275114","url":null,"abstract":"Introduction. The covid pandemic has caused a delay in diagnosis and early detection of oncological diseases, which in the future will be accompanied by a short-term decrease in the registration of new cancer cases, and then an increase in the number of surgical interventions, including on the respiratory organs. Anesthesiological support in thoracic surgery includes perioperative control of oxygenation and hemodynamic parameters, changes in which can negatively affect the postoperative period and increase the frequency of perioperative complications.\u0000Objective: To study the specifics of the impact of various methods of perioperative anesthesia during surgeries on the respiratory organs, using the evaluation of the hemodynamics and oxygenation indicators.\u0000Materials and methods. There were included 180 patients with lung cancer who underwent thoracotomy at the Kyiv City Clinical Hospital No. 17 from 2018 to 2021 within an open noncommercial randomized controlled clinical trial. Patients were randomized into four groups. Multimodal analgesia (MA) group: according to the concept of pre-emptive analgesia, 1 hour before incision - patients received 1000 mg of paracetamol intravenous, as well as dexketoprofen 50 mg intravenous, in the postoperative period dexketoprofen and paracetamol were administered every 8 hours, + epidural anesthesia: administration of 40 mg of 2% lidocaine solution during catheter placement, in the postoperative period - ropivacaine 2 mg/ml (3-14 ml/h). Thoracic epidural anagesia (TEA) group: epidural anesthesia: administration of 40 mg of 2% lidocaine solution during catheter placement, in the postoperative - ropivacaine 2 mg/ml (3-14 ml/h). Preemptive analgesia (PA) group: according to the concept of preemptive analgesia, 1 hour before incision - patients received 1000 mg of paracetamol intravenous, as well as dexketoprofen 50 mg intravenous, in the postoperative period dexketoprofen and paracetamol were administered every 8 hours.\u0000Control (C) group: patients received dexketoprofen 50 mg intravenous and opioid analgesic intramuscularly as needed.\u0000Results. There were not observed any statistically significant differences in the groups by age, height, weight, degree of anesthetic risk (ASA), blood loss, duration and volume of surgery (p>0.05). A 10-15% decrease in hemodynamics was noted after epidural support with subsequent need for infusion therapy prior to induction of general anesthesia. An increase of the frequency of manifestations of hypotension, itching at the injection site, and urinary retention were observed in the MA and TEA groups in the postoperative period.\u0000Conclusion. Epidural analgesia in thoracic surgery has a number of negative complications in the perioperative period, taking into account the lack of statistical difference (p>0.05) in groups according to oxygenation indicators, the use of a multimodal approach without the use of epidural support reduces the frequency of complications at all stages of complex t","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116596723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE INFLUENCE OF THE NUMBER OF INJURED ANATOMICAL PARTS OF THE BODY IN PATIENTS WITH MINEEXPLOSIVE WOUND ON THE RESULTS OF PAIN TREATMENT AT THE STAGES OF TREATMENT","authors":"I. Kuchyn, V. Horoshko","doi":"10.25284/2519-2078.4(101).2022.275113","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275113","url":null,"abstract":"Mine-explosive wounds in the structure of combat medical casualties during the Anti-Terrorist Operation/Joint Forces Operation accounted for 25 %. Chronic pain in such patients was diagnosed in 87.2 % of cases. Such wounds are characterized by significant damage to the body. There are no data on the effect of the number of injured anatomical parts of the body. Given that the number of injuries is related to body surface area, the findings of our study may have important implications for pain management in such patients.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126082534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANESTHESIOLOGY IN THE LIGHT OF THE TRANSFORMATIONS OF THE THEORY OF STRESS AND ADAPTATION. PERSPECTIVE OR SKEPTICISM OF PRACTICAL USE? (literature review)","authors":"V. Y. Lysenko","doi":"10.25284/2519-2078.4(101).2022.275119","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275119","url":null,"abstract":"The article attempts to analyze the main modern transformations of the theory of stress and adaptation and the possibility of implementing anti-stress adaptation reactions of general anesthesia. One of the central non-specific mechanisms of stressor injury has been found to be the stimulation of free-radical processes as a result of the often concomitant hypoxemia / hypoxia and the prooxidant effects of catecholamines. Data on the regulatory and adaptive effect of FR products (AOS and nitrogen) in the regulation of gene expression and increased production of antistress proteins, stimulation of mitochondrial biogenesis and normalization of energy metabolism are presented. The discussions of the \"apologists\" of adaptology about the \"integral\" indicators of the type of adaptation and the functional state of the organism are given. Emphasis is placed on the anesthesiologist's understanding that the organism is a relatively open selforganizing and self-structured dissipative system, as well as a critical view of the mathematical method of evaluating adaptation processes in the organism.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"29 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129549786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PHARMACOKINETICS AND PHARMACODYNAMICS OF PROPOFOL AND DEXMEDETOMIDINE DURING ELECTIVE PROCEDURAL SEDATIONS AND CHARACTERISTICS OF THEIR COMBINATION (LITERATURE REVIEW)","authors":"M. Pylypenko, B. Mykhaylov","doi":"10.25284/2519-2078.4(101).2022.275116","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275116","url":null,"abstract":"In the previous publication, we outlined the general principles of procedural sedation (PS), the depth of suppression of consciousness and spontaneous motor activity, the minimum quantity of patients' pre-procedural examinations and the aspects of informed consent obtaining. The principles of vital signs monitoring, patients' immobilisation, and the detection and treatment of adverse events have been described. A key aspect of the PS is the readiness to ensure patency of the airways and oxygenation at least one level deeper than the existing level of the PS. \u0000In this publication, attention is focused on the pharmacokinetics and pharmacodynamics of propofol and dexmedetomidine - the main drugs for elective PS and on the combination between them. In a future publication, we plan to characterize other key medications for PS, such as midazolam, ketamine, thiopental, and fentanyl. \u0000Propofol is a short-track anaesthesia drug, and it was the most widely distributed in the 21st century because after its use patients quickly and fully regain consciousness. At the same time, to achieve the necessary deep level of sedation and prevent unintended movements of the patient, it is often required to use high doses of propofol that can cause clinically significant suppression of the patency of the upper respiratory airways, depth of breathing, and hemodynamic. Therefore, in this publication, we promote the implementation of multimodal sedation and analgesia with the use of moderate doses of several drugs, which allows a significant reduction in the dose of propofol and thus increase the safety of PS. Dexmedetomidine has both sedative and analgesic properties with a minimal effect on the patency of the upper airways and the depth of breathing, thus is the best drug to combine with propofol in PS. \u0000In children, intranasal administration of dexmedetomidine and midazolam is an important alternative method of premedication, which provides a gentle entry into sedation and prevents the child's stress reactions to the placement of a venous catheter. Although the use of dexmedetomidine in children's practice is still \"off-label\" and outside the indications approved by the FDA in this publication we provide evidence to justify its safety and effectiveness of its usage in paediatrics PS.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"62 11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128452749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RELATIONSHIP BETWEEN SEDATION, PATIENTS' LEFT VENTRICULAR EJECTION FRACTION AND FREQUENCY OF NEED FOR SYMPATHOMIMETIC AND INOTROPIC SUPPORT IN PATIENTS AFTER CARDIAC SURGERY IN THE EARLY POSTOPERATIVE PERIOD","authors":"Y. Plechysta, S. Dubrov","doi":"10.25284/2519-2078.4(101).2022.275115","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275115","url":null,"abstract":"Introduction: Most patients who are indicated for cardiac surgery are patients with reduced left ventricular ejection fraction (LVEF). Also, most patients after cardiac surgery receive sedation, which, in combination with reduced LVEF, can lead to severe hemodynamic disturbances. Whether there is a relationship between the drug for sedation in the early postoperative period in patients after cardiac surgery and the initial left ventricular ejection fraction until the end, there is still no consensus. \u0000Purpose: To monitor the relationship between the drug for sedation, the patients' initial left ventricular ejection fraction and the frequency of the need for sympathomimetic support and inotropic support in the early postoperative period. \u0000Materials and methods: A randomized controlled parallel study was conducted. The study included 194 patients over 18 years of age who underwent cardiac surgical treatment using artificial blood circulation. The control point for evaluating the effect of sedation on hemodynamics was the use of inotropic and sympathomimetic therapy and the analysis of the frequency of use in groups with different ejection fractions of the left ventricle. An assessment of the frequency of vasopressor/inotropic therapy without taking into account the sedation strategy was also carried out. Statistical data processing was carried out on the basis of GraphPad Prism 9.0 software. \u0000Results: In the group receiving propofol sedation (n=95), 83.16 % (n=79) of patients received inotropic/vasopressor therapy, which is 40.72 % of the total number of patients in all 3 groups (n=194). In the group receiving received sedation with dexmedetomidine (n=16), 81.25 % (n=13) received supportive inotropic/vasopressor therapy, which is 6.7 % of the total number of patients in all 3 groups (n=194). Patients who were sedated with a combination of these drugs (n =83) received supportive inotropic/vasopressor therapy in 91.57 % (n=76) of cases, which is 39.18 % of the total number of patients in all 3 groups (n=194). (p = 0.2093). When analyzing the frequency of use of inotropic therapy in each LVEF group, regardless of the type of sedation, it was found that the frequency of use depended on the fraction of LVEF emission below 55 % (p=0.0484). When comparing the groups of patients with LVEF ≥ 55 % and LVEF 40 – 30 %, more patients with PV 40 – 30 % received inotropic support (p=0.0299 RR 0.7878 95 % CI 0.6542-0.9528). No difference was found in the frequency of use of inotropic support when comparing LVEF ≥ 55 % and LVEF≤ 30% (p=0.7474 RR 0.9103 95% CI 0.7255-1.275), PV 55 – 40% and PV 40 – 30 % (p=0.4527 RR – 1.592) \u0000Conclusions: According to the conducted study, in patients in the early postoperative period after cardiac surgery, no influence was found between the strategy of sedation, the output fraction of the left ventricle and the frequency of use of norepinephrine, dobutamine, dopamine or their combination (p=0.2093). But it was found that inotropic/v","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129276580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHO SAFE SURGERY CHECKLIST IMPLEMENTATION IN UKRAINE: MEDICAL PERSONNEL COMPLIENCE AND OTHER ASPECTS","authors":"K. Bielka, I. Kuchyn, M. Frank, I. Sirenko, D. Sazhyn, H. Fomina","doi":"10.25284/2519-2078.4(101).2022.275111","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275111","url":null,"abstract":"Summary. WHO surgical checklist is an effective tool for human-related adverse perioperative event prevention. Although it’s implementation often accompanied by different challenges. \u0000The objective of the study was to evaluate the quality of implementation of the modified WHO surgical checklist and to identify the main barriers to its completion. \u0000Materials and methods. A retrospective analysis of 366 medical records of patients that undergoing a Cesarean section was performed during the period from 1 October 2022 to 5 January 2023 and the accompanying checklists to evaluate their completion. \u0000Results. The average checklist completion rate was 94.2 %. The least filled field was “specimen labelling” and “date and time” in the final section (87.9%, n = 190), the most – patient identification, informed consent to anesthesia, presence of the relevant laboratory data and obstetric history, readiness of the anesthetic equipment, known allergies (100 %, n = 216). Among the checklists’ sections, fields were most unmarked in the “end of procedure” section (91.7 % filled), followed by the “preoperative assessment” (94.5 % filled) and most rarely in the “preinduction assessment” (95.5% filled). \u0000Conclusion and recommendations. The results of the study indicate the average compliance of the medical staff to filling out the surgical checklist «Safe Surgery» in the Kyiv City Maternity Hospital No. 5, and the high completeness of the filled checklists. Failure to complete the checklist was most often associated with urgent surgical interventions. Analysis of compliance of medical personnel and the quality of filling out checklists is an important and mandatory component of improving the safety of surgery and anesthesia.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124132631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECT OF NONIVASIVE POSITIVE-PRESSURE VENTILATION ON OUTCOME IN PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED CONTROLLED TRIAL","authors":"I. Diomin, S. Dubrov, F. Glumcher","doi":"10.25284/2519-2078.4(101).2022.275110","DOIUrl":"https://doi.org/10.25284/2519-2078.4(101).2022.275110","url":null,"abstract":"Non-invasive positive pressure ventilation (NiPPV) is known to be effective in hypercapnic respiratory failure. However, some uncertainty still exists regarding its use in certain subgroups of patients with main consideration that, if ineffective, NiPPV delays time to intubation and may worsen the outcome. 58 subjects with acute exacerbation of COPD, resulting in ICU admission, were included into the randomized, single-blind, controlled study. Study group was treated with NiPPV in PSV or BiLevel mode and increased FiO2, control group – with O2 therapy only. Medical therapy was prescribed to study participants regardless of their group allocation. Rate of tracheal intubation in study group was 7 (25 %) compared to 20 (67 %) in control group (p<0,0001). Relative risk reduction (RRR) was 61,5 % (95 % CI 23-80 %) and absolute risk reduction for study group was 42,0 % (95% CI 17,6-62). Mortality rate in the control group was 36.6 % (11 deaths), while in the study group the mortality rate was 21.4 % (6 deaths). Relative risk of death for the study group in comparison with the control group was found at the level of 0.56 (95 % CI 0.25 – 1.29). Relative risk of death reduction was 43.4 % (95% CI 28.7 – 75.1). Absolute risk of death reduction was 15.2 % (95% CI 5.39 – 38.2). The hospital lengths of stay in the study group was 20.8±11.3 days, in the control group 29.1±12.3 days (p=0.063). Regarding ICU length of stay, no significant difference was found between the groups: 14.7±12.2 days and 10.8±7 days in the control and study groups, respectively (р=0.178). \u0000Conclusion: we found evidence in favor of efficacy of NiPPV in COPD patients with acute exacerbation in terms of mortality and tracheal intubation. No difference in hospital and ICU length of stay was found. No evidence of additional risk, related to NiPPV, were found.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115205739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}