Central and pulmonary hemodynamic parameters have been studied by total body and transthoracic plethysmography in 60 patients before surgery, after surgery and on the 2nd, 4th and 9th day of the postoperative period. Neuroleptanalgesia and postoperative intramuscular analgesia with analgesics have been performed to control patients. Test patients during surgery and for 18 hours postoperatively have been subjected to upper thoracic epidural anesthesia with trimecaine and morphine. Marked stress hemodynamic reaction in control patients right after surgery and its following gradual inhibition with signs of right ventricular overload corresponded to a complicated clinical course. Reduced right ventricular afterload in test patients, minimum changes in right-ventricular performance and inotropic properties in combination with uncomplicated clinical course make it possible to consider the use of prolonged epidural anesthesia justified in thoracic cancer surgery.

Anesthesia, Epidural↗

PubMedDate not supplied

[Perioperative dynamics of the parameters of acid-base equilibrium in patients with lung cancer in relation to the type of anesthesia].

Acid-base parameters of the venous blood have been studied in 60 patients with lung cancer randomized into two groups prior to and following lung resection and on days 2, 4 and 9 postoperatively. In group I multicomponent endotracheal anesthesia using controlled lung ventilation and postoperative intramuscular analgesia with non-narcotic and narcotic analgesics were employed. In group II anesthesia and controlled lung ventilation were supplemented by epidural anesthesia with 2.5% trimecaine solution combined with adrenaline and small morphine doses at the upper thoracic segment level, postoperative analgesia for 18 hours was performed likewise. Perioperative acid-base balance changes were found to be more favourable in patients of group II, which was manifested in weaker acidosis by the end of the operation and in the absence of remote pathological changes in the acid-base balance. In patients of group I gradual repeated increase in metabolic acidosis was observed, which by day 9 postoperatively assumed a complicated clinical course.

Acid-Base Equilibrium↗

PubMedDate not supplied

[The dynamics of perioperative coagulopathies in lung cancer patients depending on the type of anesthesia and on the change in the level of endogenous intoxication].

Serum medium-size molecules (MSM) and blood coagulation parameters have been studied before and after surgery in 60 patients randomized into 2 groups. Patients in group I were subjected to multicomponent endotracheal anesthesia with neuroleptanalgesia and cardiopulmonary bypass and to postoperative analgesia with non-narcotic and narcotic analgesics. Patients in group II were additionally subjected to epidural anesthesia into upper chest segments with trimecaine + adrenaline and low morphine doses. Prior to surgery many patients showed signs of the first-degree disseminated intravascular coagulation syndrome. Parallel changes in the postoperative clinical course, pathological shifts in coagulograms and changes in MSM levels (which were maximum on the fourth day postoperatively in both groups) have been established. Patients in group II were found to have a more favourable coagulation profile.

Anesthesia, Epidural↗

PubMedDate not supplied

[Organization and volume of work in the department of anesthesiology and resuscitation in a central district hospital].

The experience accumulated during organization and functioning of an anesthesiology and intensive care unit in a central district hospital is described. The efficacy of anesthesiological aid and intensive care has been demonstrated in conditions of a rural region. The authors believe advisable the establishment of anesthesiology and intensive care units in large central district hospitals.

Anesthesia Department, Hospital↗

PubMedDate not supplied