Vol 7, No 3 (2013)


Clinical pharmacology of local anesthetics: classical concepts and new perspectives of applying in intensive therapy

Ovechkin A.M.


The chemical characteristics and pharmacokinetics of different type of local anesthetics are considered in this overview. It also summarized up-to-date data concerning systemic effects of local anesthetics and potentiality for applying them widely in intensive therapy.
Regional Anesthesia and Acute Pain Management. 2013;7(3):6-15
pages 6-15 views

The variations of postoperative analgesia for cesarean section. What to choose?

Zabolotskiy D.V., Ryazanova O.V., Mamsurov A.S., Alexandrovich Y.S., Malashenko N.S.


Inadequate analgesia after operation is one of the reasons of complications in the early postoperative period. In obstetrics this problem gains also social character: early activation for care and feeding newborn is very important for woman. The goal of the study was to assess adequacy of pain management in women after Cesarean Section. The study included 139 patients. All of them were undergone the operation under spinal anesthesia. Two methods of analgesia were compared in early postoperative period and the patients were randomized into two groups for this purpose. The first group received combination of ketoprofene with the transversus abdominal plane block (TAP) and the other group received standard options of analgesia (ketoprofene+promedol). The study results showed that efficiency of analgesia in TAB-block group was higher that was confirmed by assessment made with rating verbal scales of pain. Opioid and non-steroid drugs consumption was much higher In standard analgesia group. The level of a cortisol and prolactinum was lower in patients from TAB-block group. Early activation was also registered in patients of this group. Hence, combination of the TAB-block with non-steroid agents provides high level of an analgesia, increases patient's comfort, and allows providing full care of babies starting from the first days after operation.
Regional Anesthesia and Acute Pain Management. 2013;7(3):16-20
pages 16-20 views

Experimental study of fluid loss following puncturing the dura mater by spinal needles of different types

Sitkin S.I., Sazonov K.A., Subot V., Pozdnyakov O.B., Ronenson A.M., Volod’ko S.N.


Cerebrospinal fluid loss after a puncture of the dura mater is the main cause of postdural puncture headache (PDPH). The aim of the study was to investigate the loss of fluid from the experimental model of the dural sac, after the puncture needle Quincke and Whitacre size 25G. 180 punctures were performed in an experimental model of dural sac, specially developed for this purpose. The dura mater withdrawn from 20 cadavers. Maximum leakage was detected at a puncture needle Quincke with a perpendicular direction of the end. Puncture needle Whitacre and Quincke with parallel direction end of the needle caused a similar loss of fluid. The minimum flow time was 2 minutes. Conclusion: After dural puncture needle of 25 G, in the range from 2 to 60 minutes, the closing of the perforated holes and stopping fluid leakage. Quincke needle puncture perpendicularly along the fibers of the dura mater is accompanied by a significantly greater leakage of saline.
Regional Anesthesia and Acute Pain Management. 2013;7(3):21-25
pages 21-25 views

Multimodal combined anesthesia in lung surgery patients with low functional respiratory reserve

Gruzdev V.E., Gorobets E.S.


Multimodal combined anesthesia (MMCA) as a three-component thoracic epidural blocade with small doses of fentanil, ropivakain and adrenalin in combination with endotracheal anesthesia with sevofluran provides reliable anesthesiologic defence, early extubation and postoperation rehabilitation in patients undergone thoracic operations. This rationale gave grounds to apply this method in patients with lung cancer accompanied by COPD and severe impairment of ventilation reserves. We demonstrate successful experience of MMCA application in 13 patients including 8 patients undergone pneumonectomy. Baseline parameters of spirometry in all patients were lower than conventional limits of functional operability.
Regional Anesthesia and Acute Pain Management. 2013;7(3):26-30
pages 26-30 views

Two-level brachial plexus block for operations on proximal parts of upper extremity in patient over 70 years old

Dubinenkov V.B., Lyuboshevskiy P.A., Larionov S.V.


The goal of the study was to determine the efficacy and safety of two-level brachial plexus blockade in patients over 70 years old undergoing operations on proximal parts of upper extremity. The study included 34 patients (operation on trauma of shoulder joint, upper and middle third shoulder)/ Patients were divided into 2 groups. Two-level brachial plexus block was performed in study group: interscalene block was combined with supraclavicular and sub clavicular blockade, the block of superficial cervical plexus and intercostal brachial nerve was also performed. One-level block of brachial plexus (interscalene block and supraclavicular) in combination with block of superficial cervical plexus and intercostal brachial nerve was performed in control group. Visual analog scale (YAS) was used to assess pain level. The following characteristics were taken in account: patient's satisfaction of anesthesia and analgesia, the number of inadequate blocks and complications. Results: two-level brachial plexus blockade performed for surgery on proximal parts of upper extremity is more reliable, provides better quality of anesthesia and postoperative analgesia and doesn't increase complications incidence.
Regional Anesthesia and Acute Pain Management. 2013;7(3):31-34
pages 31-34 views

Selected chapters from monograph «Spinal Anesthesia in Obstetrics» Chapter 6. Neurophysiologic basics of spinal anesthesia

Shifman E.M., Filippovich G.V.


Clinical course of spinal block, intensity of its manifestation, quality of spinal anesthesia and occurrence of complications are mainly caused by level of local anesthetic distribution in subarachnoid space. Several factors responsible of this process and consequently neuraxial block are currently found out. The presented lecture considers the most clinically significant factors.
Regional Anesthesia and Acute Pain Management. 2013;7(3):35-49
pages 35-49 views

Importance and interpretation of standard error of mean in clinical study and trial

Tikhova G.P.


This paper highlighted the meaning and difference between standard error of mean and standard deviation as well as describes the factors that affect the values of this statistical parameters.
Regional Anesthesia and Acute Pain Management. 2013;7(3):50-53
pages 50-53 views

Uniform requirements for manuscripts submitted to «Regional Anesthesia and Acute Pain Medicine» journal

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Regional Anesthesia and Acute Pain Management. 2013;7(3):54-58
pages 54-58 views

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