PAIN, ANAESTHESIA & INTENSIVE CARE最新文献

{"title":"CAUSES AND CONSEQUENCES OF ANESTHETIC EMERGENCIES IN UKRAINE","authors":"K. Bielka, I. Kuchyn, M. Frank, I. Sirenko, A. Yurovich, D. Slipuha, I. Lisnyy, S. Solyarik, A. Mazur, G. Posternak","doi":"10.25284/2519-2078.2(99).2022.265836","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265836","url":null,"abstract":"Anesthesia-associated mortality has decreased during the last three decades as a result of several measures undertaken to improve patient safety. These included analysis of critical incidents and errors that occurred during the anesthesia, as well as factors that contribute to such incidents. Such factors may be related to the patient, operation or anesthesia. According to our study the most common incidents were related to the respiratory system: difficult airway, reintubation, oxygen desaturation; cardiovascular system: hypotension, tachycardia, bradycardia, hypertension, collapse; massive hemorrhage.\u0000Anesthetic emergencies occur rather often in Ukraine and impact the treatment results significantly. Notification, registration and analysis of such incidents are not being performed systematically, which proves to be one of the major threats to patient safety during anesthesia.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129504391","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":"MONITORING OF COGNITIVE DYSFUNCTIONS AFTER CORONARY ARTERY BYPASS","authors":"V. Antonenko, S. Dubrov","doi":"10.25284/2519-2078.2(99).2022.265835","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265835","url":null,"abstract":"Introduction. The problem of the development of cognitive dysfunctions, both immediate complications of anesthesiologic support of cardiac surgical interventions, and long-term cognitive changes in the distant term, is gaining importance with the increase in the frequency and expansion of the volume of operations in cardiac surgery practice.\u0000The purpose of the work is to investigate the state of cognitive function in the early and delayed postoperative period in patients with coronary heart disease who underwent coronary bypass surgery.\u0000Materials and methods. A retrospective analysis of the disease histories of 213 patients with coronary artery disease, who underwent coronary bypass grafting without the use of artificial blood circulation on the Shalimov National Institute of surgery and transplantology of the National Academy of Sciences of Ukraine during 2019-2021.\u0000Results and discussion. In preoperative MMSE testing, patients scored 27.51±2.54 points, on the 3rd day after the operation – a significant decrease in the indicator to 23.32±1.43 points, on the 6-8th day after the operation, the patients scored 24.98±1.71, after 6 months – 25.27±2.31 points (р≤0.05). The results of the Trial Making Test (part A) showed that at the initial level, on average, 29.41±1.55 s, cognitive functions weakened: on the 3rd day – 34.63±2.26 s, on the 6-8th day – 32 ,71±3.32 s. 6 months after the operation, the test results were 31.31±2.33 s. The second part of the Trial Making Test (part B) showed the results: before the operation – 69.22±3.41 s, on the 3rd day – 74.27±2.76 s, on the 6-8th day – 73.42±2 .65 s, after 6 months – 70.23±2.97 s. 6 months after the operation, only 15 patients (15.31%) out of 98 people with POCD had cognitive functions restored to the level of the preoperative period.\u0000Conclusions. POCDs were detected in 46.0% of patients with coronary heart disease who underwent coronary bypass surgery, while 84.7% of them remain in the distant term up to 6 months after discharge.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"206 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128547255","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":"METHODS OF LABOR ANALGESIA BY DETERMING THE LEVEL OF CHILDBIRTH SATISFACTION","authors":"S. Cherniaiev, S. Dubrov, S. Sereda, M. Denysiuk, S. Konkevych","doi":"10.25284/2519-2078.2(99).2022.265841","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265841","url":null,"abstract":"Introduction. Paroxysmal sympathetic hyperactivity (PSH) can occur as a result of brain injury, hypoxic brain damage, acute cerebrovascular accident (ACVA). The clinical picture of PSH is caused by excessive sympathetic activity and includes transient paroxysms of tachycardia, hypertension, hyperventilation, hyperthermia, and diaphoresis. PSH is a neurological emergency, which in the vast majority of cases is a diagnosis of exclusion. Lack of adequate detection and treatment of the disease leads to a high mortality rate. The diagnosis is exclusively clinical, so other pathologies must be excluded. Currently, the most widely accepted diagnostic criteria for PSH are the criteria proposed by Baguley et al.\u0000Case description. Patient D., 29 years old, was hospitalized with a diagnosis of middle cerebral artery stroke. The patient had attacks which were characterized by tachycardia, hypertension, tachypnea with asynchrony with the ventilator, diaphoresis and hypertension every day with a frequency of 2-3 times per day and were ending approximately 30-40 minutes after the onset. The diagnosis of PSH was established according to the score on the scale proposed by Baguley et al., 25 points (17 or more points – a probable diagnosis of PSH).\u0000Conclusions. It is believed that the cause of PSH is a violation of the inhibition function of the cortex on the brain structures located below, as a result of which paroxysms of sympathetic activation occur, manifested by tachycardia, hypertension, hyperventilation, diaphoresis, and hyperthermia. In this clinical case, resolution of paroxysms was observed faster with the combination of morphine and propofol. An important aspect of therapy is adequate rehydration therapy to compensate for fluid losses due to hyperthermia and diaphoresis, as well as the administration of beta-blockers on an ongoing basis","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122159802","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":"PREMEDICATION IN ANESTHESIOLOGIC PRACTICE. LITERATURE REVIEW","authors":"Y. Lisun, L. Zenkina, S. O. Savchenko","doi":"10.25284/2519-2078.2(99).2022.265833","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265833","url":null,"abstract":"Premedication – medical and non-medical preparation of the patient for surgery or examination, which will take place with or without general anesthesia. The use of premedication is an urgent problem in anesthesiology. In recent decades, approaches to premedication have changed. The use of potent drugs to promote smooth induction of anesthesia and reduce salivation has been revised with the advent of modern intravenous and inhalation anesthetics, which have far fewer side effects and faster onset of action. Specific needs are met depending on the emotional and physical condition of the patient and the type of procedure. The article deals with the use of premedication to prepare the patient for anesthesia and to provide optimal conditions for surgery and diagnostic manipulations. The article uses our experience and publications for the period 2010-2020, which are included in the scientometric search databases Cochran, GoogleScholar, PubMed, EMBASE.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123626477","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":"METHODS OF LABOR ANALGESIA BY DETERMING THE LEVEL OF CHILDBIRTH SATISFACTION","authors":"A. Romanenko, Y. Kuchyn","doi":"10.25284/2519-2078.2(99).2022.265839","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265839","url":null,"abstract":"Introduction. Woman’s satisfaction with childbirth is associated with adequate labor analgesia [1]. Negative labor experience could increase the risk of poor mother-child connection, breastfeeding problems [2], and decreased desire for elective caesarian section [3]. Effective management of labor pain and positive childbirth experience improve the quality of maternity care [4].\u0000Aim. Explore correlation between different pharmacological/non-pharmacological methods of labor analgesia at ‘’home’’/hospital environment with positive childbirth experience.\u0000Methods and materials: There are 321 women who completed questionnaire of childbirth experience. Survey consists of 4 parts: ‘’own capacity’’, ‘’professional support’’, ‘’perceived safety’’, ‘’participation’’. In postpartum period, women were divided into 4 groups with: patient-control epidural analgesia (PCEA) (n=217), nitrous oxide (50:50) (n=18), alternative methods of labor analgesia in ‘’home’’ environment (n=46) and hospital birth without pharmacological analgesia (n=40). Logistic regression was used to analyze the risks.\u0000 Results. The study shown the risk of unsatisfactory assessment of Childbirth Experience Questionnaire in the sections “perceived safety” (p=0,034, OR=2,03 (95% CІ 1,06–3,86)), ‘’professional support’’ (p=0,006, (OR=2,58 (95% CІ 1,31–5,07)), increased for patients with severe pain (VAS 7 points), compared with patients for VAS <7 points. PCEA is considered to be standard of labor analgesia and is not associated with the risk of unsatisfactory assessment in sections “perceived safety” and ‘’own capacity’’ (p>0,05). Nitrous oxide and alternative methods of analgesia shown higher rates of childbirth satisfaction in the sections ’’participation’’ (p=0,029, OR=0,48 (95% CІ 0,25–0,93), ‘’own capacity’’(р=0,040), and low rates in ‘’professional support’’ (p=0,029, OR=1,91 (95% CІ 1,07–3,41).\u0000Conclusions. An effective strategy to increase level of childbirth satisfaction is to provide positive communication with women and to inform about risk of using pharmacological/ non-pharmacological labor analgesia","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114471211","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}