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V A Beresnev

Publications and source records attributed to V A Beresnev.

11 recordsLinked to original sources
PubMedDate not supplied

[Preventive analgesia: a new trend in anesthesiology. An idea born and developed at the P.A. Herzen Institute of Oncology].

The authors summarize positive experience gained in the use of preventive anesthesia in oncosurgery. The new trend in anesthesiology has been developed at P. A. Herzen Institute of Oncology since the end of the eighties. A peripheral analgesic (aspisol, ketoprofene, ketorolac, etc.) was added to traditional premedication and anesthesia protocols in 522 patients subjected to extensive cavitary and other than cavitary surgery. Hemodynamic and metabolic parameters, homeostasis, stress criteria (hydrocortisone and glucose), pain intensity according to the verbal evaluation scale were studied at all stages of anesthesia and postoperative period, and side effects of postoperative analgesia were analyzed. Use of nonsteroid antiinflammatory drugs before the intervention and in the postoperative period prevented the development of strong postoperative pain and notably decreased the need in opioid analgesics in the presence of stable homeostasis. No serious side effects of analgesics, including hemorrhagic complications, were observed.

Adult↗
PubMedDate not supplied

[Ketoprofen (ketonal): a drug for preventing and treating postoperative pain].

A prophylactic approach to the management of postoperative pain is described: ketoprofen, a nonsteroid antiinflammatory drug, was used, which possesses numerous advantages and a variety of dosage forms. To cancer patients subjected to extensive radical operations on the pelvic organs, head, and neck, ketonal (ketoprofen) was injected intramuscularly or rectally in a dose of 100 mg 1 h before surgery and in a daily dose of 300 mg during the postoperative period. Adequate postoperative monoanalgesia with ketonal was attained in 47% patients. In the rest patients ketonal was combined with medium-potent opioid tramadol. A more potent opioid buprenorfin (sangesik) in the minimal daily dose of 0.3 mg was required in only 2 cases. Nonsteroid antiinflammatory drug ketoprofen (ketonal) in therapeutic doses administered preventively before surgery intramuscularly or rectally notably decreased the acuity of the postoperative pain syndrome.

Administration, Rectal↗
PubMedDate not supplied

[Preparations for peripheral and segmental level protection of the patient in the system of general anesthesia and postoperative analgesia].

The traditional general anesthetics and opioid seem to be insufficient for complete protection of the patient from operative trauma in major surgery. The prospective study has been done in 2 groups of patients undergoing abdominal oncological operations with multimodal general anesthesia based on midazolam, propofol, phentanyl and calipsol in microdose in preventive and postoperative analgesia by ketoprofen in the 1st group (35 cases) and the same general anesthesia in combination with prolonged epidural anesthesia with ropivacaine. Both complete anesthesia and postoperative analgesia have been achieved in each group of the patients, but in the 2nd group the doses of generally introduced analgesics with central action--phentanyl and calypsol--were threefold and twofold less, respectively, and restoration of gastric and intestinal peristalsis was more rapid (1.5 day) vs control group (3.5 days). The importance of using all the mentioned components of anesthesia and analgesia before, during and after operation to prevent the defects of antinociceptive protection and subsequent development of postoperative pain syndrome has been pointed out.

Adult↗
PubMedDate not supplied

[Use of analgesics with peripheral action in the system of complex protection of the patient from operative trauma].

Obtained for many years experience of perioperative using of analgesics with peripheral effect is summarized. The special scientific analysis was carried out in 274 patients who got different analgesics with peripheral action (aspisol, baralgin, ketoprofen, ketorolak, contrikal) at different stages of preoperative period in combination with opioid. The control group included 30 patients who got monoanalgesia by promedol after abdominal operations. The dynamics of pain, hemodynamics, respiration, gas-exchange, blood coagulation and rheology indices as well as side effects of analgesics were estimated. The best results have been obtained in cases with preventive therapy by non-steroid anti-inflammatory drug 1 hour before beginning of operation and subsequent therapy continuation after operation. Under such conditions complete analgesia after operation with moderate traumaticity is achieved in combination with low dose of small opioid (tramal) in daily dose of 235 mg. The introducing of non-steroid anti-inflammatory drugs was not followed by any hemorrhagic complication, and as was evident from electrocoalugraphic data improved blood rheology. After severe traumatic abdominal or thoracal operations non-steroid anti-inflammatory drugs are used in combination with other potent analgesic with peripheral action--cortical and opioid buprenofine in minimal dose of 0.35 mg/day with good analgesic effect. To prevent the central sensitization during general anesthesia ketamine in microdose 0.5-1.0 mg/kg*hour is always used. The conclusion is made on the important role of multimodal preventive and continuous perioperative antinociceptive protection.

Analgesia↗
PubMedDate not supplied

[Norfin in oncological practice].

A synthetic opiate agonist-antagonist norphin (buprenorphin) has been studied in 297 cancer patients as an analgetic component of general anesthesia, in postoperative analgesia and in the treatment of chronic pain syndrome. In modified neuroleptanalgesia based on norphin, diazepam, droperidol and N2O the patient is more adequately prevented from surgical trauma than in conventional neuroleptanalgesia based on fentanyl. This is confirmed by greater stability in circulation, metabolism and stress hormone parameters, however this anesthesia technique is less manageable and may be accompanied by prolonged postanesthesia depression of the central nervous system. Good results have been obtained when norphin pills were used sublingually for the treatment of long-lasting intensive chronic pain syndrome in incurable cancer patients. Norphin is no less effective than morphin, however, unlike morphin, it causes no severe adverse reactions.

Adult↗
PubMedDate not supplied

[Lornoxicam (xefocam) as an agent for the prevention and treatment of postoperative pain among other nonsteroidal anti-inflammatory drugs].

Lornoxicam (xefocam) as an agent of perioperative antinociceptive defense was studied and compared with other nonsteroidal anti-inflammatory drugs (NSAIDs) (ketorolac, ketoprofen). A comparative study was performed in 140 cancer surgical patients who were mainly middle-aged and elderly (51 +/- 10.9 years) and who had various concomitant diseases (ASA II-III). Extensive oncological operations under multicomponent general anesthesia were performed in these patients on the abdomen (n=60), small pelvis (n=46), and head and neck (n=34). All NSAIDs were used on the principle of preemptive analgesia, by intramuscularly injecting the therapeutic dose of an analgesic 40-60 min before surgery and by further continuing this basic therapy in combination with an opioid after surgery. Thirty patients received lornoxicam (xefocam, 16 mg/day), 30 had ketorolac (ketanov, 60-90 mg/day), 30, ketoprofen/ketonal (200 mg/day), and 20 patients, ketoprofen/artrozilene (320 mg/day). A control group comprised 30 patients who did not receive NSAIDs. In the patients of all the groups, the anesthesia scheme included one more antinociceptive agent--the kininogenesis inhibitor contrical (the total dose was 50,000-60,000 ATrU) (beginning from the stage of induction) and its administration (30,000 ATrU/day) was continued within 2 days after surgery. The studies performed have established that lornoxicam (xefocam) used in therapeutic doses shows a 50% reduction (versus 30% when ketorolac or ketoprofen is used) in a need for the potent opioid bepronorfine after extensive operations for cancer is one of the most effective NSAIDs. It has been noted that a short-term course of perioperative therapy with NDAIDs does not cause complications or side effects if individual contraindications to and limitations on their use are followed.

Adult↗
PubMedDate not supplied

[Nonsteroid anti-inflammatory agents (acelysin) in postoperative analgesia and intensive care].

Efficacy of nonsteroid antiinflammatory drugs in the system of postoperative intensive care of patients to relieve postoperative pain, reduce the aftereffects of surgical injury to tissues, and thromboembolic complications is pathogenetically validated. A high efficacy of water-soluble acetylsalicylic acid, acelysin, in patients after extensive oncologic surgery is demonstrated. Acelysin had a good analgesic effect without side effects and permitted reducing the dose of opiates for postoperative analgesia by 3 times in comparison with the control group. Acelysin infusion in the immediate postoperative period reliably prevented thromboembolic complications and ruled out the necessity of resorting to heparin. Acelysin is regarded as a special nonopiate component of postoperative intensive care noticeably improving its efficacy.

Abdomen↗
PubMedDate not supplied

[First experience in the use of a new Russian narcotic analgesic prosidol in oncology].

Prosidol, a new Russian narcotic analgesic, was used in various dosage forms (buccal and oral tablets, injection solution) in 113 cancer patients for the treatment of chronic pain, as a component of total anesthesia, and for postoperative analgesia. The best results were attained with the universal noninvasive dosage form, buccal tablets, used for the treatment of chronic pain in incurable patients. Analgesic properties of buccal prosidol are close to those of tramadol, the drug is well tolerated by the patients and causes no grave side effects. As a drug for postoperative analgesia prosidol was highly effective in patients after extracavitary oncologic surgery and less effective after thoracal and abdominal interventions. As a component of total anesthesia prosidol is inferior to fentanyl and approximately similar to promedol. An advantage of prosidol is its highly effective universal noninvasive dosage form, buccal tablets, which may be used for rapid analgesia in any situation.

Administration, Buccal↗
PubMedDate not supplied

[New possibilities in prevention and correction of postoperative suppurative-septic complications and multiple organ failure in oncological surgery].

The functional status of the oxidative-antioxidative system was studied in 72 patients after vast cancer operations. Traditional surgical treatment and its combination with intraoperative irradiation were shown to lead to tense antioxidative defense and to suppressed T-cell immunity and to call for antioxidative and immunomodulating therapy. High intraoperative blood loss complicated by hemorrhagic shock injured the oxidative-antioxidative system greatly. The magnitude of this damage correlated with the rate of prehypoxia. Addition of the potent antioxidant Ceruloplasmin to the drug regimen normalized a recovery period, helped to correct posthypoxic multiorgan insufficiency, to recover oxidative-antioxidative balance, and to decrease the incidence of pyoinflammatory complications. Patients with endogenous intoxication showed activated lipid peroxidation, decreased functional activity of antioxidative defense components and of T-cell immunity in homeostasis. The use of Ceruloplasmin and Laprot had pronounced antiinflammatory and detoxifying effects on the patient's body and activated its antioxidative defense.

Adjuvants, Immunologic↗