[Preoperative care and anesthesia in patients with diffuse suppurative peritonitis].
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Biomedical subjects
Publications and source records attributed to I S Ismaĭlov.
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Under examination there were 59 elderly and senile patients with acute cholecystitis subjected to emergency operations. It was found that among 3 kinds of initial narcosis smooth course was notable in the phentanyl-sombrevin initial narcosis. The administration of thalamonal-sombrevin initial narcosis results in a certain inhibition of blood circulation, and gives adequate anesthesia during endotracheal intubation. The initial sombrevin narcosis is followed by inhibition of blood circulation and fails to give sufficiently deep anesthesia during intubation of the trachea.
A complex examination of central hemodynamics and contracting function of the heart was performed in 85 patients in the preoperative period. It was established that the toxic phase of peritonitis is characterized by the disturbed central hemodynamics and worse contracting function of the myocardium which are found to aggravate the process in the terminal phase and to require intensive prophylactic and curative measures. The authors consider that the shock index and coefficient of the functional state of central hemodynamics can be used in urgent cases for the assessment of the functional state of blood circulation.
The authors analyze results of the treatment of 537 patients with acute gastro intestinal hemorrhages. All the patients were subjected to intensive therapy for the maintenance and recovery of vital functions of the organism. When the intensive therapy failed to give the necessary results the question was solved in favour of surgical interventions.
Moradol was used for postoperative analgesia in 39 patients subject to urgent surgery. Promedol was used as a control. It has been found that a marked pain syndrome in the early postoperative period in patients examined was characterized by certain deviations of the parameters studied. Moradol, as compared to promedol, has a better analgesic effect, causing milder respiration and hemodynamic changes. With intravenous drug injection, a more profound analgesia is associated with a greater respiratory depression.