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Biomedical subjects

A V Sitnikov

Publications and source records attributed to A V Sitnikov.

18 recordsLinked to original sources
PubMed2003

[Information method of EEG analysis in anesthesiology].

An information concept of nociceptive impulses is proposed. The device for quantitative analysis of information coming to CNS has been constructed and approved. It is demonstrated that monitoring of informative loading of EEG may be used for evaluation of anesthesia adequacy. Level of this index from 40 to 50% corresponds to effective protection.

Adult↗
PubMed2003

[Long-term outcomes of balloon angioplasty for aortic coarctation].

From 1994 to 2001 balloon angioplasty was fulfilled for 19 patients aged from 4 to 28 (mean 11.0+/-7.0) with discrete type aortic coarctation. Early outcomes were satisfactory in all cases. Catheterization showed 10 mm Hg decrease in systolic pressure gradient (SPG). Long-term results (from 6 months to 8 years, mean 3.0+/-2.5) were evaluated with transthoracic EchoCG, Doppler ultrasound, duplex scanning of iliofemoral segment and CT-angiography with 3D reconstruction. Surgical outcomes were considered good when SPG did not exceed 20 mm Hg for Doppler ultrasound and 25 mm Hg for Doppler EchoCG. In the study group there was statistically significant decrease in arterial pressure in right upper limb and SPG (measured with both Doppler EchoCG and Doppler ultrasonography) and rise of ankle-brachial index. Beneficial hemodynamic effect was detected in 15 from 19 patients (79%). Recoarctation has developed in 4 (21%) patients, in 1 (5.3%) case it was combined with true posttraumatic aortic aneurysm. Three patients underwent open surgical intervention with uneventful postoperative period. Aneurysmal dilatation of thoracic aorta has developed in 1 patient (5.3%), non-progressive intimal dissection - in another one (5.3%), 2 patients (10.5%) experienced ipsilateral 40-60% stenosis of right external iliac and femoral arteries. Thus good long-term outcomes of balloon angioplasty in patients with discrete type aortic coarctation were achieved in 79% cases. Patients after balloon angioplasty must be assessed regularly with non-invasive diagnostic methods such as Doppler ultrasonography, Doppler EchoCG, CT-angiography.

Adolescent↗
PubMed2000

[Genetic and morphological variability of the gastropod mollusk Nucella heyseana (Mollusca, Gastropoda) in the environmental optimum and pessimum].

Genotypic variability at six allozyme loci and six morphological shell characters was examined in 450 individuals (four samples) of mollusk Nucella heysana from the Vrangel' Bight (Nakhodka Bay) and the Vostok Bay (Peter the Great Gulf, Sea of Japan). An analysis of variation in allele frequencies showed that each of the two localities (Vostok and Nakhodka bays) in the analyzed region is inhabited by a single, albeit genetically heterogeneous, population. A canonical analysis and an analysis of variance of individual heterozygosity (Ho) and morphological variation indicate an association between Ho and morphological variation depending on habitat (interaction) in settlements in the Vrangel' Bight and, to a lesser extent, in the Vostok Bay. These results indicate that, in extreme environmental conditions, allozyme phenotypes may be selected either themselves or as markers of genes linked with them.

Animals↗
PubMed1995

[Electrophysiology of the central nervous system in effective anesthesia].

In authors' opinion, the more precise methods for controlling the depth and efficiency of general anesthesia are those which are based on the direct control over the intraoperative status of the central nervous system which reflects the time course of the status in question. Whether monitoring of the early components of somatosensory evoked potentials could be used for multimodality anesthesia was analysed. As high as 50% or lower decreases in the amplitude of the complex N19-P23 were typical of adequate defense, irrespective of anesthesias. The authors provide evidence for the efficiency of their procedure for controlling the depth and efficiency of general anesthesia. Some electroencephalographic phenomena of anesthesia were analysed with computed monitoring. The authors showed that there was a relative value of such signs of inadequate anesthesia as interhemispheric asymmetry by the leading spectral frequency and the power index of deep rhythms. Despite the procedure used (neuroleptic analgesia, ataralgesia, inhalation anesthesia, etc.), the effective anesthesia exhibited pronounced power peaks, otherwise there was a chaotic activity of the central nervous system. The physiological and clinical values of the phenomena detected are discussed in the paper.

Anesthesia, General↗
PubMed1990

[Study of xanthine oxidase activity in the brain tissue after administration of dalargin during myoplegia].

Effect of Dalargin (40 micrograms/kg) on xanthine-oxidase (X) activity in experimental Arduan-induced myoplegia (0.1 mg/kg) was studied in the brain tissue of 70 rats under inhalation anesthesia and artificial ventilation. Neither Dalargin nor Arduan was found separately to induce statistically significant changes in X activity. Dalargin injections in myoplegia caused significant (24.7%) reduction of the enzyme's activity.

Androstane-3,17-diol↗
PubMed1990

[A new method of general anesthesia in pulmonary surgery using dalargin instead of narcotic analgesics].

Intraoperative and early postoperative parameters of the central hemodynamics, oxygen transport function and acid-base status of the blood, and blood lactic and pyruvic acid levels in patients under general anesthesia with dalargin were compared to those under traditional neuroleptic analgesia. The comparative evaluation allowed for a conclusion that general anaesthesia with dalargin provides for a reliable anesthesiological defence and exerts a lower deteriorating effect on the vessels of pulmonary circulation than traditional neuroleptic analgesia.

Adult↗
PubMed1988

[Trans-sternal organ-sparing interventions in the surgical treatment of bilateral bullous diseases of the lungs].

Generalization of an experience with using the transsternal access for the simultaneous treatment of the bilateral bullous disease of the lungs in 14 patients is presented. Under analysis were the nearest and long-term results (up to 18 months). Technical aspects of the surgery of bullous disease and its bilateral form in particular were considered. Postoperative complications were hemorrhage and paresis of the right diaphragm cupola. There were no lethal outcomes. An experience of other surgeons in this field is analyzed.

Adult↗
PubMedDate not supplied

[Electroencephalogram, informational saturation of electroencephalogram, and bispectral index during xenon anesthesia for laparoscopic operations].

The depth of xenon anesthesia was never evaluated by modern methods of EEG monitoring, and hence, we studied changes in EEG, INEEG, and BIS during different stages of xenon narcosis and evaluated the possibility of using these values as criteria of xenon anesthesia adequacy. The study was carried out in 60 patients during laparoscopic operations on abdominal organs. The patients were divided into 2 groups receiving different gas anesthetics (xenon or nitric oxide). The results indicate that xenon monoanesthesia caused dose-dependent changes in the native and treated EEG; xenon is a good inhalation anesthetic providing adequate anesthesia for little traumatic operations even in case of mononarcosis; INEEG and BIS monitoring during xenon anesthesia allows an objective evaluation of its depth.

Anesthesia, Inhalation↗
PubMedDate not supplied

[The first experience in using sevoflurane].

The paper analyzes the first experience in using the halogen-containing anesthetic sevoflurane, which is new for Russia, as an agent for initial narcosis and anesthesia maintenance in adult patients. For induction, delivery of sevoflurane was initiated in a dose of 0.7 r.% through the mask of an anesthetic-respiratory apparatus. After 3-5 breaths, the dose of sevoflurane was increased up to 2 r.%. The time of inhalation to the level of INEEG being achieved 40-45% was 3.2 +/- 0.5 min, while that with propofol was 3.3 +/- 1.0 min. Initial inhalational anesthesia was smooth, which did not exclude a slight short-term motor activity in 2 patients. Sevofluorane has a pronounced hypnotic, but a weak analgesic effect in adults, which requires the co-administration of fentanyl. Sevofluorane will be mostly demanded for initial narcosis and anesthesia maintenance in children and for the induction and maintenance of anesthesia in ambulatory anesthesiology and thriving one-day hospitals. The foregoing does not rule out the use of servofluorane for the induction and maintenance of anesthesia in adults.

Adult↗
PubMedDate not supplied

[To the effective concentration of xenon].

The present literature discusses what effective concentration of xenon may be used to induce adequate anesthesia. To examine the analgesic properties of the substance, 38 patients undergone laparoscopic operations for calculous cholecystitis under informational saturation EEG (INEEG) monitoring were included into this study. All the patients were divided into 3 groups in accordance to the mode of anesthesia maintenance and INEEG monitoring. In Groups 1 and 2, the concentration of xenon was maintained at 70%; INEEG monitoring was made in the of-line mode. In Group 3, the concentration of xenon was gradually decreased from 70% to the minimum value at which the level of INEEG was 40-50%, which corresponds to the adequate depth of anesthesia. The use of 70% xenon concentration and the standard doses offentanyl (3.1 +/- 1.6 microg/kg/h) resulted in excessively deep anesthesia (38 +/- 4% INEEG). Reduction of the dose of fentanyl on an average to 1.5 +/- 0.8 microg/kg/h permitted more adequate anesthesia; however, an excessively deep anesthesia is encountered in 40% of cases, as evidenced by INEEG. The active use of INEEG monitoring in Group 3 makes it possible to perform an adequate anesthesia (46 +/- 4% INEEG) and to determine the xenon concentration necessary for this, which is equivalent to 42 +/- 11% with the dose of fentanyl of 0.9 +/- 0.8 microg/kg/h.

Acalculous Cholecystitis↗
PubMedDate not supplied

[Internal audit based on the recording critical incidents: the first results].

The critical incident concept on which an internal medical audit is based has been proposed to comparatively assess different protocols of anesthesiological support. The purpose of this study was to develop a procedure and to implement it at an anesthesiological unit. The study included and analyzed 361 anesthesiological supports. The list of critical incidents (CIs) contained 53 items and was divided into 8 main groups. CIs were recorded in 42.1% of anesthesias: a total of 304 CIs were noted and the frequency of CIs (the number of recorded CIs per anesthesia was 0.84). The bulk of CIs was associated with the cardiovascular system and varying allergic reactions. The study also yielded data on the distribution of CIs in relation to the type of anesthesiological support, the type of a surgical intervention and the physical status of a patient (according to the ASA classification). This study has only opened a little way to internal audit and showed the importance of its routine use to assess different procedures for anesthesiological support.

Adult↗
PubMedDate not supplied

[Metabolic effects of mexidole during cardiosurgical operations using extracorporeal circulation].

The effect of mexidole on the levels of glutathione, the activity of its metabolic enzymes, glutathione reductase (GR) and glutathione peroxidase (GP), and antioxidative enzymes, superoxide dismutase (SOD) and catalase (CAT) in the red blood cells under hypothermic perfusion was studied. A total of 96 patients were examined. The study was performed before perfusion, at the cooling and warming stages, an hour after perfusion, and in the morning of a following day. Mexidole was administered to 26 patients in the evening, before surgery, and at the cooling and warming stages (Group 1). The agent was not given to 70 patients (Group 2). In Group 2, there was an association of the level of glutathione and the activity of the enzymes under study with temperature. There were the least changes observed at 30-34 and 26-29 degrees C and a substantial decrease (by more than 30%) at the cooling stage as compared with pre-perfusion values. In the mexidole group, the content of glutathione increased under all temperature conditions at the study stages (by 30 to 58%) and the activity of all the test enzymes: GR and GP up to 33%, SOD up to 20-60%, CAT by 20-30%. The elevated level of all the parameters was also preserved on the following postoperative day. It may be suggested that mexidole activates the biosynthesis of glutathione and antioxidative enzymes, thus enhancing the antioxidative defense of cell membranes.

Antioxidants↗
PubMedDate not supplied

[Prospects of using non-narcotic analgesics in present-day methods of general anesthesia].

Efficacies of several relatively new methods of anesthesia are compared. The data of electroencephalographic monitoring, early components of somatosensory evoked potentials, parameters of the central and peripheral hemodynamics (pulsometry supplemented with estimation of photoplethysmography coefficient, among other things), acid-base balance, were used as criteria of the adequacy of analgesia. A total of 369 anesthesiologic modalities are analyzed, which were compared with traditional and modified neuroleptanalgesia (NLA) with inhalation of fluothane vapors. A high efficacy of NLA carried out in parallel with inhalation of gaseous anesthetics (fluothane) was confirmed. If traditional NLA is used in long traumatic operations, fentanyl in dose at least 10 mcg/(kg.h) should be infused during the main stage of the intervention to provide effective anesthesia; during cardiopulmonary bypass surgery fentanyl dose should be at least 15 mcg/(kg.h). Use of moradol as the principal analgesic in surgery on the open heart and aorta and in long traumatic interventions on the thoracic and abdominal organs was found unjustified. Combined total anesthesia with fentanyl, droperidol, seduxen, dalargin, and clofelin may be effectively used for intraoperative protection in interventions of any kind. Clinical significance of the phenomena detected is discussed.

Analgesics, Non-Narcotic↗
PubMedDate not supplied

[Monitoring of the informative saturation of EEG: a new method for intraoperative assessment of antinociceptive defense of the organism].

EEG is the result of brain activity aimed at processing the external and internal information. Intraoperative pain (as a specific type of information) developing because of inadequate anesthesia increases the total amount of information on the EEG. A new original method is proposed for assessing the efficacy of analgesia, based on computer monitoring of information saturation of EEG in the on-line regimen during an operative intervention under combined total anesthesia. Physiological and clinical significance of the detected phenomena is discussed.

Adolescent↗