Anesteziologiia i reanimatologiia最新文献

{"title":"[COMBINED SPINAL-PARAVERTEBRAL ANESTHESIA IN TOTAL HIP ARTHROPLASTY.]","authors":"V. A. Koriachkin, M. A. Liskov, M. Maltsev, M. Mohanna","doi":"10.18821/0201-7563-2016-61-5-357-360","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-357-360","url":null,"abstract":"BACKGROUND\u0000Optimizing analgesia in total hip arthroplasty contributed to the idea of combined use of spinal and paravertebral anesthesia.\u0000\u0000\u0000THE AIM\u0000the clinical evaluation of combined spinal-paravertebral anesthesia in patients undergoing total hip ar- throplasty.\u0000\u0000\u0000MATERIALS AND METHODS\u000067 patients were divided into groups: at the first a combined spinal-paravertebral anesthesia (KSPA) was used, the second - a combined spinal-epidural anesthesia (CSEA). The location of the lumbar plexus was determined by ultrasound scan. Spinal component was provided 0.5% ropivacaine solution. In the perioperative period propofol infusionfor sedation was used. After operation infusion of 0.2% ropivacaine solution at a rate of5-6 ml/hour was started through the catheter for 48 hours. The postoperative period was assessed pain intensity on a 10-point visual analog scale (VAS), the needfor analgesics, incidence of complications and patient satisfaction with the quality of anesthesia.\u0000\u0000\u0000RESULTS\u0000The lumbar plexus at the L2-3 level was in 29,9%- immediately after the release ofthe intervertebral holes, in 67.2%- in the psoas major muscle at L4-5 level of 80.1% in the psoas major muscle. In both groups postoperative pain intensity within 48 hours does not exceed 3, VAS scores. The frequency of complications in the postoperative period was against the background of paravertebral blockade of 18.2%, against the backdrop of epidural analgesia - 26 5%. 90.1% ofpatients in the first group and 82.4% ofpatients in the second group were fully satisfied with the chosen method of anesthesia (p> 0.05).\u0000\u0000\u0000CONCLUSIONS\u0000Combined spinal-paravertebral block for total hip arthroplasty is an effective and safe method of pain relief.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"3 1","pages":"357-360"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88795699","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":"[POSTRESUSCITATION CICATRICIAL TRACHEAL STENOSIS. CURRENT STATE OF THE PROBLEM - THE SUCCESSES, THE HOPES AND DISAPPOINTMENTS.]","authors":"V. Parshin, M. Vyzhigina, M. Rusakov, V. Parshin, V. Titov, A. Starostin","doi":"10.18821/0201-7563-2016-61-5-360-366","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-360-366","url":null,"abstract":"BACKGROUND\u0000Currently, the trend continues to increase the number ofpatients with cicatricial tracheal stenosis (CTS). Therefore, prevention and treatment ofthis disease remains topical. The main cause ofcicatricial tracheal stenosis is damaging the trachea during mechanical ventilation. The scheme ofprevention of this disease in Russia hasn't brought the desired results.\u0000\u0000\u0000THE AIM\u0000to clarify the modern etiology of cicatricial tracheal stenosis, to identify the trend in incidence rates, to determine whether there is an optimal safe alternative to tracheostomy including the use of minimally invasive techniques, to improve diagnostic and therapeutic algorithm at various stages of assistance, and also to study the results of innovative operations and new ways of maintaining gas exchange.\u0000\u0000\u0000MATERIALS AND METHODS\u00001128 patients with cicatricial tracheal stenosis was treated from 1963 to 2015 in Petrovsky National Research Centre of Surgery and IMSechenov First Moscow State Medical University. Over time methods of di- agnosis, methods of anesthesia and operations have been varied. In this regard all patients were divided into two groups depending on the period of time from 1963 to 2000 (297 patients) andfrom 2001 to 2015 (831 patients). In recent decades there is a steady increase in the number of treated patients. So, if in the first group during the year operational treatment about the CTS 8,0 patients were underwent, in the second - to 55.4. Cicatricial tracheal stenosis appeared after lung mechanical ventilation at 1025 (for 90.9%) patients. They have undergone both radical one-stage treatment and multi-stage and sequential intraluminal procedures. In general there is a clear trend towards more aggressive surgical tactics. So, if in thefirst group, the tracheal resection with anastomosis was performedin 59 patients only, the second-330. Thefrequency ofpostoperative complications and mortality in the second group ofpatients was 12.9 and 0.7 %, respectively.\u0000\u0000\u0000RESULTS\u0000Only a reasonable combination of all treatment methods, the principle of \"every patient his own version of operation\" allows to minimize the risk oftreatment and to get a good lasting result. Proof of such provision may be the fact that the frequency of complications and postoperative mortality at our patients have had a tendency to decrease and currently stands at 12.9 and 0.7 %, respectively for many years. It is 2.3 and 9.6 times less, respectively, than in the periodfrom 1963 to 2000. It appears that further reduction of these indicators will be at a slower pace, afurther solution of the CTS problem will be based on the prevention of disease.\u0000\u0000\u0000CONCLUSION\u0000Prevention of cicatricial tracheal stenosis in the departments of reanimation and intensive care is currently inadequate. It requires fundamentally new approaches, but reform still has not brought the desired results. Diagnosis of the CTS at an early stage allows early treatment and to avoid complex and risky operations. Increasingly","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"16 1","pages":"360-366"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85816903","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 ROLE PLEIOTROPIC EFFECTS OF CALCIUM CHANNEL BLOCKER LERCANIDIPINE IN PERIOPERATIVE THERAPY OF ARTERIAL HYPERTENSION.]","authors":"M V Melnik,&nbsp;I I Afonicheva,&nbsp;A V Beloborodova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This review presents the data of assessing antihypertensive efficacy and tolerability vasoselective high-lipophilic the 3d generations calcium channel blocker lercanidpine. The inhibition of the calcium ions flow through the membranes of smooth muscle cells of blood vessels causes peripheral, cerebral, renal and coronary vasodilation decreasing total peripheral vascular resistance and, consequently, blood pressure (BP) lowering and improve regional circulation. During reception of lercanidipine the level of norepinephrine remains the same even when using high doses of the drug. Negative inotropic effect does not occur therefore, lercanidipine can be used in the treatment of myocardial ischemia. Renal protection properties slow down the development and progression ofchronic renalfailure (CRF). The drug can be successfully used in patients with arterial hypertension, chronic renalfailure, diabetic and non-diabetic nephropathy. Lercanidpine also may be effectively used in the treatment of hypertension with associated clinical conditions: bronchial asthma, chronic obstructive pulmonary disease, bradiarrythmias, atrioventricular blockade 2-3 degree, sinus node dysfunction, peripheral arteries deseases with symptoms of the extremities ischemia, sleep disturbance, depression, dystonia, asthenic and cephalgic syndme in the frame of the cerebrovascular insufficiency manifestations. Therapy with lercanidpine, in addition to lowering blood pressure, can help to nephroprotection, neuroprotection, antianginal effect, the regression of left ventricular hypertrophy, improvement of lipid metabolism and glucose tolerance. With over 30 years experience in the application and modification of the molecular structure, slow the onset of action and superior long-lasting effect reception of letranidipine well-tolerated and provides a high adherence ofpatients to the treatment of hypertension.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"395-398"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869834","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":"[A COMPARISON OF TWO APPROACHES FOR INTRAOPERATIVE LEVOSIMENDAN ADMINISTRATION IN CARDIAC SURGICAL PATIENTS WITH SEVERE LEFT VENTRICLE DYSFUNCTION.]","authors":"V V Pasyuga,&nbsp;S I Belov,&nbsp;E S Yusupova,&nbsp;R R Adzhigaliev,&nbsp;S A Berezhnoy,&nbsp;O S Panov,&nbsp;D G Tarasov,&nbsp;A G Yavorovsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>It is proved that levosimendan administration improves overall outcome and reduces mortality in high risk cardiac patients. However up to now there is no optimal scheme of its use in intraoperative settings.</p><p><strong>The aim: </strong>To compare two approaches of levosimendan administration in patients with left ventricle ejectionfraction less than 35% who underwent cardiac surgery.</p><p><strong>Materials and methods: </strong>After approval by the local ethics Committee, 40 patients older than 18 years with severe preoperative left ventricular dysfunction (left ventricle ejection fraction less than 35%), who were planned for cardiac surgery operation with cardiopulmonary bypass and cardioplegia were randomly assigned to two groups of 20 patients each. In group I (n=20) infusion of levosimendan started intraoperatively after induction of anesthesia, a loading dose of 6 mg/kg with subsequent injection of a dose of 0.1 μg/kg/minfor 24 hours. In group 2 (n=20) bolus of levosimendan 24 μg/kg was injected 15 min before aortic clamping. Anesthesia and methods of cardiopulmonary bypass in the groups did not differ Results. We got thefavorable clinical results in a group of 'full\" levosimendan dose (12.5 mg as a daily infusion with an, initial bolus of 6 mg/kg just after the induction of anesthesia) in terms ofreduction of the total dose ofsympathomimetics andpostoperative troponin T level in comparison with the group where levosimendan was administered as a single bolus. (24 mg/kg) 15 minutes prior to aortic clamping.</p><p><strong>Conclusion: </strong>Based on these data it can be assumed that the use of prolonged infusion of levosimendan in a dosage of 12.5 mg is preferable to a single bolus 24 μg/kg.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"334-338"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869917","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":"[USING A VISUAL ANALOGUE SCALE FOR ASSESSING THE SEVERITY OF PAIN SYNDROME AFTER CESAREAN SECTION, DEPENDING ON THE METHOD OF ANESTHESIA.]","authors":"E. Nedashkovsky, S. Sedykh, E. Zakurdaev","doi":"10.18821/0201-7563-2016-61-5-372-376","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-372-376","url":null,"abstract":"THE AIM\u0000To compare efficiency of various techniques of anesthesia after Cesarean section on degree ofpain expression in randomized clinical trial.\u0000\u0000\u0000MATERIALS AND METHODS\u0000120 puerperas aged from 21 till 33 years who were undergone to Caesarean section were studied. Patients were divided into four equal groups by number of observations. In groups 1st and 2nd patients were performed local anesthesia with continuous and bolus anesthetic. In group 3rd were performed bilateral blockade of the cross-space belly. In the 4th groups was used multimodal analgesia system. Each patient during the postoperative period was estimated the severity ofpain on a visual analog scale at rest and movement at 3, 6, 12, 24 and 48 hours.\u0000\u0000\u0000RESULTS\u0000Intensity ofpain after surgery in patients of all groups decreased and reached lows of 48 hours after a Cesarean section. At the same time the 2nd group ofpatients (6,1 ? 1,4) had pain significantly less than that ofpuerperas from the 3rd and the 4th groups (13,2 J 2,4 and 18,0 ? 2,7). Meanwhile, indices offemale patients pain severity from the 1st and 2nd groups of the study were not statistically different. When studying distribution ofpatients on degree ofpostoperative pain it is established that atpuerperas of the 1st and 2nd group pains prevailed weak (47% and 67%) and moderately expressed (50% and 33%). In the 3rd group expression of a pain syndrome in all cases was moderate. In the fourth group the pain syndrome was considerably more expressed (the moderated - 53%; the strong - 4 7%).\u0000\u0000\u0000CONCLUSION\u0000Pain syndrome after Cesarean section using the localanalgesia with continuous or bolus is reduced by 28-35%, which was significantly more than the blockade of the cross-space stomach and systemic analgesia.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"6 1","pages":"372-376"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77651151","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":"[PERIOPERATIVE MANAGEMENT OF PATIENTS WITH DIABETES MELLITUS.]","authors":"V V Likhvantsev,&nbsp;T S Zabelina,&nbsp;O A Grebenchikov,&nbsp;M A Shapkin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article is devoted to the existence of the problem of intraoperative provide patients with concomitant diabetes mellitus: a disease is not diagnosed in time, it increases the probability of death in the performance of surgery by 50%, where as the timely prevention and preparation reduces the chance of developing specific complications to the level of patients with the general population. The paper discusses the recommendations developed by the British Association ofEndocrinologists 2011 and Russia in 2015, as well as the Association ofAnaesthetists of Great Britain and Ireland (2015), provides practical recommendations for the preoperative preparation, anesthetic and resuscitation provide patients with concomitant diabetes mellitus.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 4","pages":"290-293"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35855164","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":"[AQUATIC AND ELECTROLYTE DISORDERS AT THE PATIENT WITH SEVERE TRAUMATIC BRAIN INJURY.]","authors":"Z G Marutyan,&nbsp;V I Kartavenko,&nbsp;S S Petrikov,&nbsp;O N Kilaseva,&nbsp;D V Khovrin,&nbsp;T G Barmina","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article is dedicated to the problem ofwater and electrolyte disturbances in patient with acute severe head trauma. We present the case study of patient with severe head injury who consistently developed diabetes insipidus and cerebral salt wasting syndrome. His water and electrolyte disorders were successfully corrected by target-oriented intensive care. Constant tight monitoring and of intensive care allowed to avoid secondary ischemic injuries till the water and electrolytic homeostasis regulation mechanisms restoration.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 4","pages":"300-304"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35855168","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":"[PROGNOSTIC SIGNIFICANCE OF CHANGES OF BLOOD GLUCOSE LEVEL IN PATIENTS WITH THORACOABDOMINAL INJURIES.]","authors":"E P Sorokin,&nbsp;S V Ponomarev,&nbsp;Ye V Shilyaeva,&nbsp;Ye A Bel'skih,&nbsp;A I Gritsan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Currently, one of the causes of high morbidity and mortality is injuries. Predict the outcome of injuries - it is an important task of the treating physician. Trauma is a stress factor so to predict the outcome, you can use markers of stress, the most accessible ofwhich is blood glucose.</p><p><strong>The aim: </strong>to reveal the dynamics of the relationship between blood glucose levels and the outlook for the life ofpatients with thoracoabdominal injuries.</p><p><strong>Materials and methods: </strong>A retrospective analysis of medical records of hospitalized patients were divided into two groups, depending on the outlook for the life of (favorable or unfavorable), and each of the groups - into two subgroups according to the presence or absence of signs of intoxication at admission. The subgroups were calculated and compared the mean blood glucose levels at different hours of hospital treatment.</p><p><strong>Results: </strong>It was found that the average blood glucose levels at various hours of hospital stay were significantly higher in patients with poor outcome. The most noticeable was the difference in the first days of hospital treatment. Signs of intoxication was associated with lower values of glucose and a tendency to hypoglycaemia. In addition, among patients with high blood glucose ( 8 mg / dL) was observed over deaths in the first day of hospital stay.</p><p><strong>Conclusion: </strong>High blood glucose levels ( 8,0 mmol / L) in the first day of hospital treatment is a predictor ofpoor outcome in patients with thoracoabdominal injuries.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 4","pages":"293-296"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35855165","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":"[ACCREDITATION OF THE HEALTH PROFESSIONAL AS A LAUNCH PAD FOR CONTINUING MEDICAL EDUCATION.]","authors":"A A Svistunov,&nbsp;Zh M Sizova,&nbsp;V N Treaubov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rapid development of medical science and health care practice, the need to improve the quality of health care, the ongoing modernization of education was the basis for scientfic rationale and implementation of the system of continuous medical education, which will be gradually expanded to cover individuals who have undergone 2016 accredited specialist.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 4","pages":"253-256"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35855733","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":"[PECULIARITIES OF ANESTHESIA DURING COCHLEAR IMPLANTATION IN PEDIATRICS.]","authors":"V B Ryazanov,&nbsp;Kh M Diab,&nbsp;N A Daikhes,&nbsp;D P Vainshtein,&nbsp;A L Vainstein,&nbsp;D S Kondratchikov,&nbsp;A R Siraeva,&nbsp;O A Pashchinina","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>The aim: </strong>analysis of the use of laryngeal mask in anesthesia for cochlear implantation.</p><p><strong>Materials and methods: </strong>10 patients aged from 1 year to 5 years were operated on according to the classical method KI with the use of laryngeal masks. As anesthesia was performed a balanced multimodal anesthesia by Sevoflurane and Fentanyl.</p><p><strong>Results: </strong>The use of laryngeal masks in all 10 cases have gave the possible to avoid the use of muscle relaxants and to clear the threshold of detection of acoustic reflexes ofstapes musclestendon, and to reduce time of surgical intervention. A short time surgery provided rapid awakening of the patient, absence of nausea and vomiting in the early postoperative period.</p><p><strong>Conclusion: </strong>use of laryngeal mask airway is reduces the time of surgery, minimize the patient's trauma, reduce input anesthetic drugs and get good results intraoperative audiological testing.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 4","pages":"272-274"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35855740","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}