Vol 8, No 3 (2014)

Articles

The overview of materials of XI All-Russian conference “Standards and individual approaches in anesthesiology and resuscitation” dedicated to the problems of regional anesthesia and postoperative analgesia

Ovechkin A.M.

Abstract

The paper presents analytical review of reports concerning actual problems of regional anesthesia and postoperative analgesia those were performed during XI All-Russian conference “Standards and individual approaches in anesthesiology and resuscitation”.
Regional Anesthesia and Acute Pain Management. 2014;8(3):5-15
pages 5-15 views

Introduction and experience of epidural anesthesia and continuous epidural anesthesia in thoracic phtisiosurgery

Buyko E.G., Mironchik S.L., Samostenko V.V.

Abstract

The paper presents analysis of introduction and experience of applying epidural anesthesia with postoperative continuous epidural analgesia for surgical treatment of pulmonary tuberculosis patients. The study included 75 patients with confirmed diagnosis of pulmonary tuberculosis manifested in two clinical forms: fibrous-cavernous tuberculosis and tuberculema in the phase of disintegration. Most of the patients have accompanying pathologies. The using of methods of epidural anesthesia and analgesia reduced the number of sanitation bronchoscopy for 27,2% comparing with applying of standard analgesia techniques.
Regional Anesthesia and Acute Pain Management. 2014;8(3):16-20
pages 16-20 views

Comparative evaluation of hemodynamics in patients using peripheral nerve block and spinal anesthesia in operations on the lower extrimities

Kokhan Z.V., Brukhnov A.V., Piacherski V.G., Marochkov A.V.

Abstract

The article presents comparative assessment of hemodynamics in patients undergone operations on lower extremities under spinal anesthesia and peripheral nerve blockade. The study included 40 patients aged from 17 to 66 years. Patients in group 1 received spinal anesthesia, while patients in the 2nd group - sciatic nerve blockade or femoral nerve block. The hemodynamic parameters were measured and recorded according to Protocol of Anesthesia and Monitoring. Baseline parameter registrations were made in the operating room before surgery and then parameters were recorded every 5 min after onset of anesthesia and before the end of surgery and the transferring patient from the operating room to the ward. Patients undergone surgery under spinal anesthesia required obligatory continuous monitoring both during transferring to the ward and in immediate postoperative period. No hemodynamically substantial changes of blood pressure were observed during surgery performed under peripheral nerve block and complete stability of hemodynamics were noted in postoperative period.
Regional Anesthesia and Acute Pain Management. 2014;8(3):21-25
pages 21-25 views

Postoperative analgesia with the use of nefopam and ketoprofen in cardiosurgical patients

Eremenko A.A., Sorokina L.S.

Abstract

The study was conducted in order to test effectiveness and safety of different schemes of postoperative analgesia in 135 patient undergone myocardium revascularization surgery and acquired heart defect corrections. Six combinations of postoperative analgesia were studied. The effectiveness and safety were approved for all of 6 postoperative analgesia schemes in cardiosurgical patients. The frequency of nausea, vomiting, dizziness and weakness was significantly higher in the group of PCA with Trimeperidine as monotherapy than in other groups. Combination of Nefopam and Ketoprofen provided the most expressed analgesic effect. Administration of Nefopam and Ketoprofen before extubation reduced the intensity of pain (in average for 50%) and promoted the early stirring up of patients. Combined administration of Nefopam and Ketoprofen provided opioid-saving effect for 79%, while 55% of patients don't need additional opioid analgesic administration.
Regional Anesthesia and Acute Pain Management. 2014;8(3):26-32
pages 26-32 views

Rationale of possibility to apply small volumes and low doses of lidocain in femoral nerve block

Marochkov A.V., Piacherski V.G., Brukhnov A.V., Kokhan Z.V.

Abstract

The goal of the study was to improve efficiency and safety of the femoral nerve blockade in patients undergoing surgery on lower extremities. Materials and Methods. The ultrasound-guided (US) femoral nerve block was performed using peripheral nerves electrical stimulator in 49 patients. The anesthesia was provided by different volumes of 0,75%, 1%, 1,5%, 2%, 3%, 4% lidocain solution. The characteristic of local anesthetic extent (complete or incomplete surrounding of femoral nerve) were evaluated on the US-device monitor during blockade. The quality of motor and sensory block was assessed within 40 minutes after block. Results. The following minimum amounts of lidocaine allow achieving complete femoral nerve blockade: 0.75% solution - 10 ml; 1% - 7.5 ml; 1.5% - 5 ml; 2% - 5 ml. Conclusion. The minimal value of local anesthetic volume and minimal lidocain amount for achieving the effective femoral nerve block was equaled to 5 ml and 75 mg correspondingly.
Regional Anesthesia and Acute Pain Management. 2014;8(3):33-39
pages 33-39 views

Selected chapters from monograph «Spinal Anesthesia in Obstetrics». Neurologic, traumatic and septic complications of neuroaxial analgesia techniques

Shifman E.M., Filippovich G.V.

Abstract

The lecture overviews frequency, etiopathogenesis, classification, clinical picture and treatment problems of neurological, traumatic and septic complications of obstetric regional anesthesia. Recommendations reducing these complications risk are discussed either.
Regional Anesthesia and Acute Pain Management. 2014;8(3):40-50
pages 40-50 views

Anesthesia in 200 kg weight patient during laparascopic hysterectomy (clinical case)

Anisimov M.A., Gorobets E.S.

Abstract

45 years old 200 kg weight female (BMI 73 kg/m 2) had been operated on for uterus cancer under combined anesthesia (desflurane general anesthesia with epidural analgesia: naropin 2 mg/ml+fentanyl 2 mcg/ml+adrenaline 2 mcg/ml). The case was used as the example, described the clinical approach to such complicated cohort of patients with the accents on patient position, intubation, respiratory and hemodynamic problems. The epidural analgesia is regarded one of the perioperative corner stones in anesthetic approach to morbidly obese patients.
Regional Anesthesia and Acute Pain Management. 2014;8(3):51-56
pages 51-56 views

Planning clinical research. Question #1: How to calculate enough sample volume?

Tikhova G.P.

Abstract

The article is dedicated to the important questions of clinical study design in particular sample size calculation enough for statistical significance testing with determined significance level and power. Calculation techniques and formulas are described in details for different data types. The paper includes examples of sample size calculating for continuous and binary variable assigned as study endpoints.
Regional Anesthesia and Acute Pain Management. 2014;8(3):57-63
pages 57-63 views

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