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Biomedical subjects

R N Lebedeva

Publications and source records attributed to R N Lebedeva.

At least 37 records · Page 2Linked to original sources

[Postoperative period and principles of intensive therapy after surgery of ischemic heart disease].

The early postoperative course (within 10 days after surgery) is analysed in 218 patients operated upon for the ischaemic heart disease. Resection and plastic repair of the postinfarction aneurysm was undertaken in 132 of them, aortocoronary bypass procedures--in 86. The peculiarities of an uneventful postoperative course are presented, the diagnosis and therapy of the complications are discussed, and the mortality is analysed.

Alanine Transaminase↗

[Perioperative myocardial infarct during the surgical treatment of IHD].

Perioperative myocardial infarction is one of the most frequent causes of death in patients subjected to surgery for coronary disease. Study of the pathogenesis of this complication may become an approach to decreasing the postoperative mortality. Forty-seven case histories and autopsy protocols of patients who died after surgery on the coronary arteries and 241 intraoperative biopsy specimens of autovenous shunts are analyzed. The mechanisms underlying the cardiomyocyte necrosis in surgical treatment of coronary disease are based on various pathological processes, the leading of which is thrombosis of the shunts and coronary arteries. The principal factors were intraoperative ischemia of autovein endothelium and shunting of coronary artery with a narrow distal bed.

Adult↗

[The problem of adequate analgesia in the postoperative period].

Despite numerous methods of drug and non-drug analgesia, acute pain relief remains a pressing problem, particularly for the postoperative period. Individual protocols of analgesia are still to be developed. Standard doses of analgesics, administered in some intensive care wards, may be inadequate in some patients. An increase of an opioid dose may lead to untoward reactions. Therefore, we consider therapy with nonsteroid antiinflammatory drugs (ketorolac) justified. An important trend in improvement of the efficacy of drug analgesia is evaluation of a sufficient analgesic dose. Patient-controlled analgesia (PCA), administered in accordance with the patient's request, is an alternative to the traditional analgesia administered according to indications (planned analgesia). The main advantage of PCS in comparison with traditional administration of analgesics are effective analgesia meeting the individual requirements of a patient, rapid desired effect, a shorter period without analgesia, stable concentration of the analgesic in the plasma, time saving for the staff, and a lower incidence of side effects. PCA has been used in 227 patients in intensive care wards of Research Center of Surgery. The majority of patients appreciate this method high, which results in adequate analgesia in 82-95% cases.

Analgesia↗