[Subdural-epidural anesthesia in clinical practice].
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Biomedical subjects
Publications and source records attributed to V A Belov.
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The original decision of permanent introduction of antibacterial means to tissues of brain at gunshot meningoencephalitis is offered. For antibacterial therapy the intra-aortal catheter with diameter of 2,5 mm (through a.femoralis) was introduced. After washing the catheter by solution of crystalloid with heparin the various combinations of preparations in 5% solution of glucose were introduced: cephalosporin--8 g/day; hentamicin and brumacilin--240 mg/day accordingly, amicacin--1500 mg/day. Speed of introduction--20-50 mg/h, total volume--500 ml. The catheter was in aorta not more than 10 days, maximum--14 days. A described technique was applied in Burdenko Main Military Clinical Hospital on 34 wounded in head. At computer tomography of brain of all wounded intracranially the splinters and bullets were revealed, clinically--meningoencephalitis. Foreign bodies have been extracted after cupping of clinical and laboratory signs of meningoencephalitis. The authors consider, that the technique is effective not only at wounds of brain, but also at suppurative meningoencephalitis of other etiology.
The article examines hemodynamic indices in patients with acute peritonitis in proximate preoperative period, taking into account etiology of the disease, a period passed from the appearance of illness and up to the performance of operation, and the scope of infusion-transfusion therapy. An algorithm of preoperative volemic preparation was worked out which made it possible to normalize hemodynamic homeostasis in patients and assure the performance of operation in more favourable physiologic conditions.
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The renin activity and gluco- and mineralocorticoid adrenalocortical function were studied in 22 patients operated mainly on abdominal organs under the conditions of ketamine anesthesia. As noted, the ketamine injection followed with hypertension and tachicardia does not give rise to the renin activity and to the 11-OKS and aldosterone blood levels, as well. An evident trend to the increase of the concentration of the adrenocortical hormones, together with the occurrence of hypokemia and progressive hyperglycemia have been traced throughout the anesthesia and operation.
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