Biomedical subjects

Aurika Karbonskiene

Publications and source records attributed to Aurika Karbonskiene.

5 recordsLinked to original sources

PubMed2006

[A role of thoracic epidural anesthesia in pulmonary resection surgery].

This article presents a review of current literature on impact of thoracic epidural anesthesia on functions of organs and systems. Its role in anesthetic management of pulmonary resection is discussed. Thoracotomy is one of the most painful surgical procedures followed by intense, acute, and chronic pain associated with post-thoracotomy. Thoracic epidural anesthesia ensures adequate analgesia in postoperative period and assists in solving problem of chronic pain. Thoracic epidural anesthesia reduces systemic stress response by inducing sensory and sympathetic blockade. Pulmonary resection produces changes in respiratory function which may result in respiratory insufficiency and other pulmonary complications. During one lung ventilation, thoracic epidural anesthesia reduces pulmonary blood shunt and improves oxygenation. Postoperatively due to effective pain relief and improvement of diaphragm function, thoracic epidural anesthesia improves respiratory function, and rate of pulmonary complications is decreased. Sympathetic blockade during thoracic epidural anesthesia reduces the rate of perioperative myocardial ischemia and cardiac mortality. It also reduces the number of thromboembolic and gastrointestinal complications and has a positive effect on immune function. Due to numerous benefits, thoracic epidural anesthesia can be recommended as a standard in pulmonary resection surgery.

Analgesia, Epidural↗

PubMed2004

Endoscopic aesthetic facial surgery: technique and results.

The endoscopic approach to forehead and midface lifting has become popular method of face rejuvenation with minimal incisions. We have performed 67 endoscopic facelift procedures in the last four years. Forehead lifting technique included five small scalp incisions, wide subperiosteal elevation, endoscopic myotomy and forehead tissue fixation with srews, superficial temporal fascia (STF) suture to deep temporal fascia (DTF). Midface lifting technique included temporal 2.5 cm and 1.5 cm vertical intraoral incision, midface subperiosteal undermining and midface elevation with cable sutures Bichat's fat to DTF. Age mediana of patients who underwent endoscopic front lift was 46, patients who had endoscopic front lift and midface lift procedure age mediana was 40. Postoperative complication rate was 7.5% and included frontal branch weakness (n=2), hematoma (n=1), infraorbital nerve paresthesia (n=1) and asymmetrical smile (n=1). The main question is the quality of the results. We have reviewed 49 patients who were followed 6 months or more. Preoperative and postoperative life-size photographs were analyzed. The mean elevation mediana at medial canthus was 2.2 mm, at medial limbus 2.3 mm, at lateral limbus 2.5 mm, at lateral canthus 2.9 mm. Midface - lift effect resulted cheek elevation from 1.07 till 4.71 mm lip corner elevation 1.03 mm to 3.27 mm. We observed cheek elevation, improving nasolabial line, increasing volume of malar region, elevating lip angles in patients after endoscopic midface lift. We have found that important advantage of subperiosteal midface lift, when performed in conjunction with endoscopic brow lift, is its ability to move the cosmetic eye unit, proportionally, leading to a harmonious facial appearance. Endoscopic facelift is effective procedure for face rejuvenation especially for eyebrows and cheek elevation.

Adult↗

PubMed2004

[Bupivacaine for continuous interscalene brachial plexus analgesia after shoulder surgery].

OBJECTIVE: This study evaluates clinical efficacy of continuous interscalene brachial plexus block with bupivacaine 0.15% for postoperative analgesia after shoulder surgery. MATERIAL AND METHODS: Eighty patients, scheduled for elective shoulder surgery, were included in this study. All patients received an interscalene block before surgery. A perineural catheter was then introduced for continuous brachial plexus analgesia. Patients were prospectively randomized in a double-blinded fashion to receive either bupivacaine 0.15% or placebo postoperative infusion through an interscalene catheter. Pain was assessed with a visual analog scale at rest and also in motion. Duration of surgery and surgery type, satisfaction scores, supplemental analgesia, side effects, circulatory and respiratory parameters were recorded. RESULTS: The bupivacaine group showed less pain at rest and in motion than the placebo group (p<0.0001), except 4 and 6 h after the brachial plexus block; a requirement for supplemental analgesia was also lower. Side effects (except weakness in the arm, which was more frequent in bupivacaine group), circulatory and respiratory parameters were comparable in both groups. Satisfaction scores were higher in bupivacaine group. CONCLUSIONS: Continuous interscalene brachial plexus analgesia is a reliable and effective method of providing postoperative pain relief after shoulder surgery and is superior to the systemic analgesia.

Adolescent↗

PubMed2003

[Anesthesia and obstructive pulmonary disease].

The article deals with the problems of perioperative management of patient with respiratory disease. The impact of general and regional anesthesia on respiratory system is discussed. Risk factors of perioperative respiratory complications are reviewed as well as general means for reducing them. Issues of anesthetic management of patients with bronchial asthma and chronic respiratory disease are discussed, putting stress on preoperative optimization of respiratory function, choice of anesthetic technique and postoperative pulmonary rehabilitation.

Adrenal Cortex Hormones↗

PubMed2002

[Comparison of electrocardiographic parameters during pneumoperitoneum in patients without cardiovascular diseases and in patients with ischemic heart disease].

UNLABELLED: Pneumoperitoneum induces significant pathophysiological changes. Changes in performance of cardiovascular system can be severe in patients with compromised cardiac function. Groups of patients to whom these changes may be deleterious are yet to be identified. Aim of the study was to elucidate the influence of pneumoperitoneum on the electrocardiographic recording. PATIENTS AND METHODS: 35 cardiovascular healthy (ASA I-II) patients (group 1) and 34 patients with underlying moderate ischemic heart disease (ASA II-IV, Goldman's cardiac risk class II-III) (group 2), scheduled for elective laparoscopic cholecystectomy, were included in the study. Premedication included sedatives for all patients and the group 2 received their usual cardiovascular treatment one hour before operation. A standardized protocol of monitoring and anesthesia was followed in the operating room. 12 lead electrocardiograms (ECG) were obtained before and after induction of anesthesia, every 10 minutes during pneumoperitoneum, after the peritoneal desufflation and after extubation. The ECGs were recorded and analysed by the means of computerized system for ECG record and analysis "Kaunas" (UAB "Kardiosignalas", Kaunas, Lithuania). The analysis was performed postoperatively. RESULTS: During pneumoperitoneum a deviation of cardiac electrical axis to the left was observed. There were no marked changes in duration of P wave, P-Q interval, and QRS complex. Following abdominal insufflation a tendency to flattening of T wave was observed returning to the initial position after desufflation. No significant dislocation of ST segment was recorded. CONCLUSIONS: The pneumoperitoneum induced changes of cardiac electrical axis can affect the interpretation of ECG seen on a cardiac monitor during anesthesia. Pneumoperitoneum does not pose patients with moderate ischemic heart disease at additional risk of developing myocardial ischemia.

Anesthesia, Endotracheal↗