Biomedical subjects

D Bochev

Publications and source records attributed to D Bochev.

7 recordsLinked to original sources

PubMed1996

[Total intravenous anesthesia (TIVA) with propofol/ketamine as an alternative for patients at risk in abdominal surgery].

Propofol/ketamine combination, used in total intravenous anesthesia (TIVA), is assayed in patients with abdominal diseases presenting surgical and anesthesiological risk of a varying degree. The aim of the study is to outline an optimal regimen of propofol infusion as a hypnotic agent and ketamine as analgetic during TIVA with a special reference to the hemodynamic effects and characteristic features of the recovery period. Anesthesia is applied to 15 patients presenting physical condition III--IV degree according to ASA and indications for various intraabdominal surgical interventions, including operations on an emergency basis. To improve anesthesia control, microprocessor infusion pumps Ohmeda and Becton-Dickinson, allowing for prompt dosage correction, consistent with individual needs, are employed. The strategy of dosing each of the drugs used is described. The basic hemodynamic parameters are followed with parallel assessment of the quality of anesthesia with a view to prevent operative stress, working conditions of the operative team, and characteristic features of the recovery period. From clinical viewpoint the technique proves to be satisfactory, and may be used as an alternative to conventional anesthesia in poor-risk patients indicated for abdominal surgery.

Abdomen↗

PubMed1996

[Is propofol (Diprivan) indicated in emergency surgery?].

Propofol is an anesthetic characterized by specific pharmacologic qualities, conditioning compliance of the clinical picture with the drug infusional rate, high-degree safety and facilitated anesthesia conduction--qualities by which it bears resemblance to inhalation anesthesia. This is an assessment of the qualities of TIVA with Propofol in poor-risk patients according to ASA, operated on an emergency basis. Proceeding from the obtained results, the inference is reached that continuous Propofol infusion provides for adequate anesthesia control and safety of the patients with heightened anesthesiologic and operative risk.

Adolescent↗

PubMed1996

[Propofol (Diprivan) in emergency anesthesia].

This is an assessment of the effect of propofol (Diprivan) as a hypnotic component of total intravenous anesthesia (TIVA) in conjunction with alfentanyl (Rapifen), securing the antinociceptive component, and atracurium (Tracrium) as myorelaxant. The aforementioned constellation is used with the goal to attain a much better control of TIVA, substantiated both pharmacokinetically and pharmacodynamically. This type of anesthesia is applied to 15 patients presenting acute surgical diseases, classified III-IV degree according to ASA. The technique used and the dosage of drugs, introduced by infusion, are described. The basic respiratory and cardiocirculatory parameters are evaluated. Assessment is done of the quality of analgesia with description of the character of the awakening and recovery phases in terms of time and quality. The preliminary study, covering patients with increased anesthesiological risk, shows that the doses given are appreciably reduced in the period of maintaining anesthesia (4-5 mg/kg/h Propofol, 1-1.5 mg/h Rapifen in patients with mean body weight 70 kg). The prophylaxis against operative stress is estimated as very good. TIVA with Diprivan/Rapifen/Tracrium lends itself readily to control.

Aged↗

PubMed1996

[Pre-, intra- and postoperative allergic manifestations in hepatic echinococcosis].

Data obtained from 502 patients operated for echinococcosis (hydatid disease) are analyzed. In 61 of them (12,15 per cent) a variety of allergic manifestations are observed before the operation. Serious allergic shocks intraoperatively, and lethal outcome due to allergic shock in the postoperative period are described. Inferences are reached about the necessity of performing mandatory examination of all allergic patients for echinococcosis as an eventual underlying cause of allergy, as well as mandatory preoperative tests for allergy to drugs and anesthetics along with undertaking antiallergic prophylaxis of patients in the postoperative period to obviate eventual allergic accidents, regardless of their presence or not in the previous history.

Adult↗

PubMed1996

[Current anesthesia problems in minor proctological operations].

Surgical interventions, performed routinely or on an emergency basis in the clinic of abdominal surgery are mostly proctologic. All patients operated in the clinic are analyzed with a special reference to the modern methods of analgesia used.

Adult↗

PubMed1996

[Problems of postoperative drug analgesia in proctological surgery].

It is the purpose of this study to analyze all practical methods of analgesia in proctologic surgery. A new procedure of intravenous or subcutaneous fentanyl analgesia is proposed.

Analgesia↗

PubMed1993

[The anesthesiological risk and treatment characteristics of patients with ischemic heart disease prepared preoperatively with beta-receptor blockers, calcium antagonists and nitro preparations].

The anesthesiologic risk in ischemic heart disease (IHD) patients undergoing noncardiac surgery is determined by the duration of myocardial infarction sustained in the past, and the degree (severity) of stenocardia manifestations. Such risk is estimated as minimal within six months after myocardial infarction in the presence of stenocardia stabilization. In this contingent of patients the anti-ischemic therapy is proceeded with in both pre- and postoperative period. The role of beta-adrenergic blocking agents (propranolol, acebutolol, esmolol, sotalol) and calcium antagonists (nifedipine, diltiazem) in the prophylaxis against intraoperative myocardial ischemia, rhythm disorders and pathologic arterial pressure rise is definitely proved.

Adrenergic beta-Antagonists↗