Vol 9, No 4 (2015)


Epidural anesthesia as a base of anesthesiological support of laporoscopic colorectal surgery in patients of elderly and senile age

Balykova E.V., Khachaturova E.A., Savushkin A.V., Gubko A.V.


The comparative evalutation of 3 different methods of anaesthesia was perfomed. Total intravenous anaesthesia and 2 methods of combined epidural anaesthesia were tested. One method using propofol as a main sedative medication, another using sevoflurane. The advantages and safety of combined methods of anaesthesia were proven to be successfully used in elderly patients. It was proven that combined epidural anaesthesia with propofol as a main sedative agent is the most balanced method due to hemodynamic stability, decreased level of narcotic drug activity, leads to a faster postoperative recovery, early extubation, decreased level of postanesthetic complications and adequate level of postoperative analgesia.
Regional Anesthesia and Acute Pain Management. 2015;9(4):5-15
pages 5-15 views

Prolonged epidural analgesia during perioperative period in patients undergone laparoscopic surgery on gastrointestinal tract

Malyshev A.A., Sviridov S.V., Sharipov R.H.


The study focused on the role of prolonged epidural analgesia in complex multimodal analgesia while performing major laparoscopic surgery. The results of evaluation of intensity of postoperative pain, post-operative physical activity and the dynamics of the parameters of central hemodynamics and respiratory function were compared in two subgroups: study group included patients operated under combined and balanced general anesthesia; the control group included patients who had undergone similar in terms of the intervention laparotomy. The results of the study demonstrated reduction of the pain and acceleration of mobilization in patients treated according the pain relief scheme which included epidural analgesia; under the influence of the latter mentioned earlier recovery of baseline blood circulation and respiration.
Regional Anesthesia and Acute Pain Management. 2015;9(4):16-20
pages 16-20 views

The influence of anesthesiological tactics on developing of cognitive disorders following endoplastic surgery on hip and knee joints

Politov M.E., Bastrikin S.Y., Bulanova E.L., Ovechkin A.M.


Cognitive disorders are frequent complications of hip and knee joint arthroplasty in aged patients. The goal of the study was to compare effects of different anesthesiological approaches on developing of cognitive disorders following hip and knee joint arthroplastic surgery. The study included 123 patient over 65 years old undergone arthroplastic surgery on large joints of lower extremities using different anesthesiological techniques: combined spinal-epidural anesthesia and continuous epidural analgesia, spinal anesthesia and multicomponent postoperative analgesia, general anesthesia and multicomponent postoperative analgesia. Concluision. Baseline cognitive deficit was the main risk factor for developing of cognitive disorders after arthroplastic surgery of hip joint. Postoperative delirium (PD) is predictor of early postoperative cognitive dysfunction (POCD). High requirement of opioid analgesics is associated with high frequency of cognitive complications. Performing of hip and knee joint arthroplastic surgery under spinal-epidural anesthesia with continuous combined epidural analgesia during first postoperative days provides reducing of PD and POCD incidence.
Regional Anesthesia and Acute Pain Management. 2015;9(4):21-27
pages 21-27 views

Epidural-sacral anesthesia as an alternative variant to spinal-epidural blocks during abdominal delivery

Matlubov M.M., Semenikhin A.A., Abidov A.K., Rakhimov A.U., Khamdamova E.G.


The goal of that study was to determine the feasibility of epidural-sacral anesthesia for abdominal delivery and to assess the effectiveness of this method. The stude includes 26 women with estimated difficulties for performing of conventional variants of anesthesia. The technique of performing epidural-sacral anesthesia is described in details as well as the subsequent monitoring of patient's status. The results of the study suggest to assert that in cases of correct technical performing the proposed variant of regional blockade provides reliable antinociceptive defense and stable hemodynamics and it also limits neuroendorine reaction to surgical aggression.
Regional Anesthesia and Acute Pain Management. 2015;9(4):28-31
pages 28-31 views

Using of transdermal therapeutic system Durogesic® for acute postoperative pain therapy in patients after craniotomy

Imaev A.A., Dolmatova E.V., Kulikov A.S., Lubnin A.Y.


Narcotic analgesics are the most powerful tool in the treatment of acute postoperative pain. The use of opioids is associated with risk of the development of potential side effects, which are particularly dangerous in the practice of neurosurgery clinic. The goal of this study was to compare the effectiveness of TTS Durogesic-matrix and NSAIDs used at the request for therapy of acute postoperative pain after craniotomy. We also assessed the effect of transdermal fentanyl on respiratory system during the perioperative period. Materials and methods: The study included 150 patients undergoing elective craniotomy for brain tu,or removal. NSAIDs used in the postoperative period on demand. Durogesik - matrix of 25 μg/h was set on the patient’s skin in advance. Postoperative pain was assessed using the visual analogue scale (VAS) at 6, 18, 30, 42, and 54 hours after surgery. Prolonged pulse oximetry monitoring of the patient’s natural sleeping was used to control the respiratory function during fentanil application and a day after transdermal system removal. Results: There was significant difference in the pain level on all stages of the study depend on the applied scheme of therapy. Pulse oximetry monitoring did not reveal depressive effects Durogesik - matrix of 25 μg/h on respiratory function. Conclusion: Use of transdermal fentanyl is much more effective and safer than NSAIDs used on demand in patients after craniotomy
Regional Anesthesia and Acute Pain Management. 2015;9(4):32-38
pages 32-38 views

Selected chapters from the monograph “Regional Anesthesia in Pediatrics'! Regional Anesthesia in vertebrology

Ayzenberg V.L., Ulrikh G.E., Tsypin L.E., Zabolotskiy D.V.


The lecture is devoted to the questions of regional anesthesia in pediatric vertebrology. The authors describe specific characteristics of the pediatric patients with pathology of spine, particularities of surgery and anesthesia, pay attention to providing of patency of airway and consider problems and techniques of neuroaxial blockades in children with spinal deformity.
Regional Anesthesia and Acute Pain Management. 2015;9(4):39-49
pages 39-49 views

Catheter breakage during epidural anesthesia

Koryachkin V.A., Mal’tsev M.P., Lis’kov M.A., Mokhanna M., Geras’kov Y.V.


Difficulties during epidural catheter removing occur rather rarely. We present the description of two such cases. Both of them were connected with using of Perifix ONE catheter. The paper discusses the reasons causing the difficulties during catheter removing, doctor’s tactics in similar situations, and indications for surgical extraction of the rest fragment of epidural catheter.
Regional Anesthesia and Acute Pain Management. 2015;9(4):50-53
pages 50-53 views

Intraoperative developing of critical bradyarrhythmia while applying of dexmedetomidine

Shmigel’skiy A.V., Polupan A.A., Kulikov A.S., Arefiev A.M.


The paper describes application features of the modern sedative drug dexmedetomidine in neurosurgical practice. The authors marked the main pharmacologic effects as well as possible side effects including the most frequent one that is bradycardia. In some cases bradyarrhythmia may become critical and demand decisive action from anesthesiologist. The paper is devoted to describing and discussing of similar clinical case, registered by the authors during providing of sedation by dexmedetomidine to perform carotid endarterectomy in conscious.
Regional Anesthesia and Acute Pain Management. 2015;9(4):54-58
pages 54-58 views
pages 59-63 views

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