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At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[Characteristics of anesthesia in trauma surgery in children with severe burn injuries].

The authors analyze total anesthesia in 347 children with thermal injuries, subjected to traumatic operations involving massive blood loss. A characteristic feature of total anesthesia in children subjected to early necrectomies was a lower dose or refusal from cholinolytics for premedication, endotracheal multicomponent narcosis with ketamine, fentanyl (promedole) in the minimal doses in parallel with inhalation anesthesia by fluothane traces and a nitrous oxide-oxygen mixture with at least 50% oxygen. The optimal initial dose of nondepolarized myorelaxants in burnt children is 30-50% higher than the recommended dose and is determined by the size and depth of injury. For controlled myoplegia, the doses of nondepolarized myorelaxants for subsequent injections should be 1.5-2.5 times lower than the initial dose. The duration of pancuronium and arduan effects depended on hepatorenal function. Tracrium provided regulated myorelaxation in children with burns even in cases with hepatorenal dysfunction. A high rate of massive blood loss and early development of multiple organ failure in children with thermal injuries prompted us to develop infusion-transfusion therapy for traumatic operations involving massive blood loss. The volume of blood loss is estimated from the area of necrotic tissues removed and the type of necrectomy. Qualitative composition of transfusion mixture and the rate of transfusion is determined by the rate and volume of blood loss, level of hemoglobin and hematocrit, and metabolic disorders during the operation. Prolonged ventilation of the lungs is recommended for children with thermal injuries after operations involving blood loss of 1 circulating blood volume or more. These measures decreased the incidence and severity of complications involving the hemodynamics, oxygen status and metabolism in tissues, and improved the reparation.

Adolescent↗
PubMed1999

[Anesthesiological accompaniment for the wounded during transport].

The authors discuss some traits of anesthesia maintenance during transportation of wounded. The study of 292 cases evacuated from Afghanistan and Chechnya, divided by two groups with different types of the anesthetics. The first group members were given by 1 ml of 2% promedol solution, while the second was sedative-controlled (associative usage of mydazolam and phentanil). When the first group suffered from pain, the second group patients were practically free from the pain stress until they reached their hospitals.

Adult↗
PubMedDate not supplied

[Effect of ether-oxygen anesthesia and of the premedication agents on the toxicity and cardiotonic effect of strophanthin].

Experiments conducted with mice, rats and cats demonstrated ether-oxygen anesthesia to reduce the tolerance of the animals to strophanthin in the LD50 and MDL tests. The premedication agents (atropine, promedol, diprazine) increased, according to observations on mice and rats, the resistance of the animals to strophanthin. In tests on dogs involving determination of the cardiac ejection by thermodilution strophanthin in a dose of 44 gamma/kg and under ether-oxygen anesthesia with premedication produced a statistically significant increase of the systolic cardiac index and well-marked bradycardia. Exclusion of thepremedicationagents drastically lowered the effect of strophanthin.

Animals↗
PubMedDate not supplied

[Use of analgesics with peripheral action in the system of complex protection of the patient from operative trauma].

Obtained for many years experience of perioperative using of analgesics with peripheral effect is summarized. The special scientific analysis was carried out in 274 patients who got different analgesics with peripheral action (aspisol, baralgin, ketoprofen, ketorolak, contrikal) at different stages of preoperative period in combination with opioid. The control group included 30 patients who got monoanalgesia by promedol after abdominal operations. The dynamics of pain, hemodynamics, respiration, gas-exchange, blood coagulation and rheology indices as well as side effects of analgesics were estimated. The best results have been obtained in cases with preventive therapy by non-steroid anti-inflammatory drug 1 hour before beginning of operation and subsequent therapy continuation after operation. Under such conditions complete analgesia after operation with moderate traumaticity is achieved in combination with low dose of small opioid (tramal) in daily dose of 235 mg. The introducing of non-steroid anti-inflammatory drugs was not followed by any hemorrhagic complication, and as was evident from electrocoalugraphic data improved blood rheology. After severe traumatic abdominal or thoracal operations non-steroid anti-inflammatory drugs are used in combination with other potent analgesic with peripheral action--cortical and opioid buprenofine in minimal dose of 0.35 mg/day with good analgesic effect. To prevent the central sensitization during general anesthesia ketamine in microdose 0.5-1.0 mg/kg*hour is always used. The conclusion is made on the important role of multimodal preventive and continuous perioperative antinociceptive protection.

Analgesia↗
PubMedDate not supplied

[Effect of premedication on the formation of postoperative pain syndrome].

The pronouncement degree and dynamics of pain syndrome were assessed after surgeries in the abdominal cavity organs with regard for a nature of the analgetic component of premedication and of the postoperative analgesic therapy (n = 155). The administration of analgesics before extra-traumatic surgeries was found to be compulsory in order to prevent the onset of a persistent postoperative pain syndrome. A combination of non-steroid anti-inflammatory drugs, i.e. ketonal, and of a high-efficiency agonist of opiate mu-receptors, i.e. bupranal, was acknowledged as most effective in coping with this task. It was demonstrated that the application of "the forestalling analgesia" by ketonal (100 mg in 30 min before the beginning of moderate- and mild-trauma surgical interventions and immediately after the finalization of such surgeries) contributed to an essentially lower pronouncement degree of the postoperative pain syndrome and made the administration of narcotic analgesics unnecessary. Finally, it is pointed out that promedol could not be regarded as a drug ensuring a safe prophylaxis of the central sensitization and hyperalgesia.

Adolescent↗
PubMedDate not supplied

[Use of epidural analgesia for the arresting of pronounced lumbar pains].

A combination of local anesthetics (2% lydokaine solution, 2 mg/kg; 0.5% bupivakaine solution, 0.4 mg/kg or 0.75% ropivakaine solution, 0.55 mg/kg), promedol (20 mg) and corticosteroids (125 mg hydrocortisone or 80 mg kenalog) was epidurally administered in 78 patients to arrest the pronounced root pain syndrome of the lumbar-sacral localization provoked by intervertebral disk hernias. The most prolonged analgesic effect was registered in groups, whose patients received bupivakaine or ropivakaine, which prevented the onset of pain before the antiinflammatory effect of corticosteroids started. The patient must be informed well in advance about the possibility of a momentary relapse of pains and about the intensification (at the same time moment) of pharmacotherapy prescribed by neuropathologist.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[The choice of a method of general anesthesia for patients with cancer of the abdominal cavity].

Two variants of anesthesiological management have been used in 135 patients with gastrointestinal tumors. The first variant was intubation anesthesia with N2O+O2, ketamine or sodium hydroxybutyrate combined with classical neuroleptanalgesia technique. Pentamine was used to potentiate protection. This anesthesia technique was used in patients under 50 who had no concomitant diseases. The second variant was used in patients over 50 with concomitant diseases. In these cases combined prolonged epidural anesthesia was accompanied in the intraoperative period with intubation anesthesia with controlled lung ventilation using N2O+O2 and additional administration of promedol and droperidol. The second variant of anesthesia not only ensured a safe intraoperative period but also optimized the management of patients in the postoperative period.

Abdominal Neoplasms↗
PubMedDate not supplied

[Opioid inhibition of oxytocin release from the posterior lobe of the hypophysis and its significance for obstetrical anesthesiology].

The review of literature presents modern experimental and clinical data on opioid inhibition of oxytocin release from posterior hypophysis lobe during pregnancy and in childbirth. The impact of various narcotic analgesics on oxytocin secretion, myometrium contractility and the condition of the fetus and newborn has been assessed. The data on oxytocin blood plasma level are of importance in the clinical practice for selecting the most suitable anesthesia technique during physiological and pathological labour, especially when modern narcotic analgesics (morphine, promedol, fentanyl, tramadol, etc.) are used.

Anesthesia, Obstetrical↗
PubMedDate not supplied

[Postoperative analgesia with nonsteroid anti-inflammatory drugs in children].

The purpose of the case-study was to evaluate the efficiency of non-steroid antiinflammatory drugs (NAD) for postoperative analgesia in children after small-scope surgical interventions. Diclofenac, 1 mg/kg per day administered as rectal suppositories or intramuscular injections after initial narcosis, was used for postoperative analgesia in children of the main group; postoperative analgesia made by analgin and promedol in the control group was compared with the former. Forty-seven children and 10 children with identical diseases like groin hernia, varicocele and dropsy of testicular membranes, were respectively in the main and control groups. Clinical examinations and registration of functional parameters were made in patients during certain time periods, i.e. before surgery (in the standing and lying postures) and after surgery (in 20 minutes, as well as in 1, 2, and 3 hours after surgical interventions). The efficiency of postoperative analgesia was evaluated by means of cardiointervalography according to Bayevsky method as well as by a state of central hemodynamics and by clinical examinations, including the visual-analogue 10-point scale and the 0-4 point verbal pain assessment scale. The postoperatively obtained data revealed a pronounced misbalance between the main and control groups, which is indicative of that the application of NAD for preventive and postoperative analgesia in children improves essentially the postoperative course and contributes to a fast rehabilitation of patients. A comparative analysis of the efficiency of postoperative analgesia by the discussed drugs showed that diclofenac possesses a sufficient analgetic activity and is free of any side-effects inherent in narcotic analgetics.

Administration, Rectal↗
PubMedDate not supplied

[Combined spinal epidural anesthesia during endoprosthetic surgeries for bone tumors in old-age children].

Thirty-five patients (ASA II-III) aged 12 to 17 years, diagnosed as having osteogenic sarcoma and Ewing's sarcoma localizing in the femur and tibia, were examined. Surgery was performed as sectoral resection of the affected bone along with knee joint endoprosthesis. Surgical intervention was made under combined spinal and epidural anesthesia (CSEA) with sedation, by using the methods for exact dosing of propofol (6-4 mg/kg x h). During intervention, a child's respiration remains is kept spontaneous with oxygen insufflation through a nasal catheter. CSEA was performed in two-segmental fashion. The epidural space was first catheterized. After administration of a test dose, 0.5% marcaine spinal was injected into dermatomas below the subarachnoidal space, depending on body weight (3.0-4.0 ml). Sensory blockade developed following 3-5 min and lasted 90-120 min, thereafter a local anesthetic (bupivacaine) or its mixture plus promedole was epidurally administered. ??Anesthesia was effective in all cases, motor blockade. During surgery, there was a moderate arterial hypotension that did not require the use of vasopressors. The acid-alkali balance suggested the adequacy of spontaneous respiration. The only significant complication we observed was atony of the bladder that requires its catheterization till the following day. An epidural catheter makes it possible to effect adequate postoperative analgesia.

Adolescent↗
PubMedDate not supplied

[Effect of nonsteroidal anti-inflammatory drugs and paracetamol on hemodynamic changes during postoperative analgesia in children].

The purpose of the present study was to comparatively assess the adequacy of postoperative analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol in children undergone "minor" surgical interventions. For postoperative analgesia in children, the authors used paracetamol in a single dose of 25-30 mg/kg, diclofenac in a dose of 1.5-2.0 mg/kg, which were rectally administered as suppositories, as well as diclofenac in the same dose as intramuscular injections (Group 1). A comparison was made with postoperative analgesia using analgin and promedole (Group 2 (control)). Group 1 comprised 63 patients and Group 2 included 26 patients with identical diseases (inguinal hernias, varicocele, phimosis). Functional parameters were recorded in patients in the lying position before, 30 min, 1, 2, and 3 hours after surgery. The efficiency of postoperative analgesia was evaluated, by using central hemodynamic parameters that many investigators consider to be one of the major criteria for the adequacy of anesthesia. Comparison of postoperative data has revealed a difference between the groups, which suggests that the use of NSAIDs and paracetamol for preventive and postoperative analgesia in children substantially improves the postoperative period and promotes a rapid rehabilitation in patients. Comparative analysis of the efficiency of postoperative analgesia of the above agents has indicated that diclofenac and paracetamol have a sufficient analgesic activity and at the same time do not show the adverse reactions unique to narcotic analgesics.

Acetaminophen↗
PubMed1991

[The effect of blood serum proteins from the seal on the analgetic action of narcotic analgesics].

The protein fraction isolated from blood of seal, Phoca groenlandica, has been found to produce hyperalgesic effect on rats exposed to thermic or electrocutaneous nociceptive stimulation, but fail to affect writhes provoked by intraperitoneal injection of acetic acid solution on mice. When combined with morphine, the fraction lowered completely its narcotic analgetic action in the above mentioned tests. On the contrary, these same proteins combined with promedol or fentanil enhanced and prolonged analgetic effect of the latter. Tested in vitro the protein showed neither opioid nor anti-opioid activity. Therefore it is reasonable to suppose that neurophysiological activity of the isolated fraction is due to the peptides formed on enzymatic hydrolysis of proteins in vivo rather than these proteins as such.

Analgesics, Opioid↗
PubMedDate not supplied

[The metabolism of drugs and endogenous substrates in the organs of rabbits following partial hepatectomy and liver ischemia].

The intensity of metabolism of hexenal, amidopyrine, phenacetin, promedol, acetone, hydrocortisone, testosterone and prostaglandin E2 by the isolated microsomes of the liver, kidneys, small intestinal mucosa and lungs was studied polarographically by the rate of oxygen absorption in experiments on 20 male rabbits four days following partial hepatectomy and liver ischemia. It was found that with both models of the liver damage there was observed a decrease of metabolism of amidopyrine, hexenal, phenacetin and an increase of metabolism of hydrocortisone and prostaglandin E2. In the lungs one could observe an increase of metabolism of the studies drugs following hepatectomy and its inhibition in liver ischemia. In the kidneys and intestine in both types of the liver damage contradirected changes in drug metabolism being of the compensatory character were observed.

Animals↗
PubMedDate not supplied

[Relationship between the pain-relieving action of narcotic analgesics and their effect on respiration].

Experiments with rabbits (30) and albino rats (110) demonstrated that morphine (1 mg/kg), promedol (trimeperidine) (2 mg/kg) and phentanyl (0.02 mg/kg), while raising by 21-24 per cent of the algesia threshold, produced an analgesic effect differeing in its duration (morphine-130 min, trimeperidine-70 min, phentanyl-17 min). This is attended by changes in respiration (greater on introduction of phentanyl, and lesser, following administration of morphine) and by shifts in the functional state of the tissues (greater on introduction of trimeperidine and lesser after aministration of morphine).

Analgesics, Opioid↗
PubMedDate not supplied

[Intrapleural anesthesia following thoracic surgery and in chest trauma].

The analgesic effect of intrapleural administration of local anesthetics (lidocaine, trimecaine, azocaine) has been studied in 180 patients after thoracic surgery and with chest trauma. The effect was assessed on the basis of subjective (visual analogue 10-score scale) and objective findings (hemodynamic parameters, spirograms, ECG). In control patients analgesia was performed by intramuscular promedol administration. It has been shown that fractionated intrapleural administration of local anesthetics is an effective and safe analgesic technique after thoracic surgery and in chest trauma.

Adolescent↗
PubMedDate not supplied

[Postoperative prolonged analgesia without the use of narcotic analgesics].

Intravenous prolonged analgesia with analgin, diazepam and no-spa was used in the early postoperative period in 59 patients with acute surgical pathology of the abdominal cavity organs. The technique used ensured a marked analgetic effect. The combination of analgin, diazepam and no-spa, as compared to promedol, promoted to an earlier recovery of the respiration function, which was an effective measure preventing the onset of pulmonary complications.

Adult↗
PubMedDate not supplied

[Changes in autonomic homeostasis during anesthesia induction in patients operated on for congenital cleft palate].

Variation pulsometry was used to study vegetative homeostasis changes over the course of induction anesthesia and tracheal intubation in children operated on for palatal clefts. The same premedication scheme was employed in all the patients. The same neuroleptic doses were administered in induction anesthesia. Induction anesthesia parallel with electroanalgesia with an Electronarcol-1 apparatus helped reduce the promedol dose necessary for adequate anesthesiologic protection from 1.2-1.4. to 0.2-0.4 mg/kg. This was associated with the minimal changes in autonomic nervous system functioning, evidencing the efficacy of electroanalgesia in induction anesthesia for this patient population.

Anesthesia, Endotracheal↗