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Biomedical subjects

V I Stamov

Publications and source records attributed to V I Stamov.

17 recordsLinked to original sources
PubMedDate not supplied

[Total intravenous anesthesia based on propofol infusion with target concentration: a new procedural solution].

Total intravenous propofol anesthesia with target control (TCI) infusion was used in 61 surgical patients (43 women, 18 men, ASAI-II). Propofol concentration in the central compartment at awakening was in high correlation with the effective concentration (Ce) at the moment of falling asleep (r = 0.64). A model investigation demonstrated the advantages of longer induction for minimization of the hemodynamic disorders. Propofol TCI in a dose of 2 micrograms/ml led to an increase in the EEG spectral potency in the 1-12 Hz range, appearance of biomodality, and a decrease in the right-side frequency. The studies helped determine the policy of intravenous propofol TCI anesthesia using the Ce values at the moment when the patient lost consciousness and the right-side frequency of EEG spectrum.

Algorithms↗
PubMedDate not supplied

[First experience with clinical use of intravenous anesthetic recofol: effectiveness and safety].

Clinical trials of a new anesthetic Recofol were carried out. This analog of well-known drug diprivan is characterized by a predominantly hypnotic effect. The effect of recofol on hemodynamics, gas exchange, and EEG was studied in 30 clinical trials during anesthesia for bronchoscopic manipulations and operations on the abdominal and thoracic organs, microsurgery, and during peripheral vessel repair. The results indicate that recofol is virtually identical to diprivan (propofol). Clinical course of induction and anesthesia, hemodynamic reactions and effect on the respiratory system of patients were virtually the same. Recofol was well tolerated, its allergenic activity was relatively low, it was rapidly metabolized, there were virtually no side effects. Positive results of recofol trials carried out by Leiras Oy firm recommend the drug for wide use in anesthesiology.

Adult↗
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[Esterase-metabolized remifentanil hydrochloride opioid (Ultiva-TM), a new step towards the solution of the problem of regulation of analgetic components of general anesthesia].

Hemodynamics, gas exchange, velocity of psychomotor recovery, pain intensity during and after laparoscopic cholecystectomy were studied in patients anesthetized (total intravenous anesthesia) by two methods: 1) remifentanyl and propofol, forced ventilation of the lungs, and myoplegia (n = 21, ASA I-III) and 2) fentanyl and propofol, forced ventilation of the lungs, and myoplegia (n = 18, ASA I-III). Total intravenous anesthesia based on remifentanyl was characterized by stability of hemodynamic and gas exchange parameters at all stages of the intervention. This method ensured a smooth and rapid course of resuscitation, characterized by absence of signs of central respiration depression, predictable normalization of psychomotor status, and low incidence of factors provoking postoperative nausea and vomiting, on condition of their prevention. Further studies of remifentanyl are needed in interventions of different degree of traumatism and within the framework of different protocols of postoperative analgesia.

Adult↗
PubMedDate not supplied

[Anesthesia during radical surgery for esophageal cancer].

The paper summarizes the experience with 245 anesthesias made in 1983 to 2002 during operations for malignant esophageal neoplasms and cardioesophageal cancer. The specific features of the perioperative period, monitoring of the function of vital viscera, the technical features of transhiatal esophagectomy, risk factors of postoperative complications and principles of their prevention are considered. The ways of optimizing anesthesiological protection during radical esophageal operations are discussed.

Adult↗
PubMedDate not supplied

[Prevention of postoperative nausea and vomiting with highly selective 5-HT3 serotonin receptors antagonists during different types of surgery].

A prospective study was conducted to examine the efficacy of highly selective, 5-HT3 serotonin receptor antagonists (Zofran, 4 mg; Latran, 4 and 8 mg; Navoban, 2 and 5 mg) during plastic and abdominal (endoscopic and routine) interventions in 165 patients aged 14 to 77 years who had ASA Classes I-III. The drugs caused no adverse reactions and were effective in controlling postoperative nausea and vomiting (PONV) after surgery under total intravenous anesthesia. In plastic surgery, Navoban, Zofran, and Latran controlled PONV in 94, 81, and 70% of cases, respectively. In abdominal surgery, Zofran (4 mg) and Latran (4 mg and 8 mg) did this in 87, 80, and 90% of cases, respectively. Risk factors for PONV are analyzed. The pathophysiological aspects of PONV and practical approaches to making an antiemetic strategy are discussed.

Adolescent↗
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[Carboxyperitoneum and clinical efficacy of nondepolarizing relaxants with different types of metabolism].

A total of 108 patients operated on the abdominal cavity were examined with laparoscopic equipment or via laparotomic assess. The recovery time of neuromuscular conduction was defined for a myorelaxant with organ-depended metabolism (pipecuronium) and, predominantly, nonorgan-depended metabolism (athracurium and cisathracurium) in relation to the type of surgical technique (laparoscopy and laparotomy). It is concluded that carboxyperitoneum prolongs the recovery of neuromuscular conduction for pipecuronium without affecting this parameter in athracurium and cisathracurium. It is more expedient to use these myorelaxants during laparoscopic operations than pipecuronium, a myorelaxant having organ-dependent metabolism.

Adult↗
PubMedDate not supplied

[Effect of carboxyperitoneum on duration of the action of some non-depolarizing muscle relaxants].

Changing pharmacokinetics of muscle relaxants with the organ-dependent metabolism (pipecuronium), which is related with the effect exerted by carboxyperitoneum on the patient-body temperature hemostasis and on the renal function are under discussion in the paper. It was demonstrated that carboxyperitoneum affects independently the decreasing body temperature and prolonged effect duration of pipecuronium. The conclusion is that the use of muscle relaxants with the prevailing organ-dependent elimination (atracurium and cysatracurium) is more preferable versus pipecuronium in laparoscopic surgery.

Adult↗
PubMedDate not supplied

[Safety and quality of myoplegia in different types of abdominal surgeries].

The efficiency of new non-depolarized myorelaxants, i.e. of rocuronium and cisatracurium, in abdominal surgery with general anesthesia (combined or total intravenous anesthesia) of 114 patients was evaluated clinically and accelerometrically. The use of the above drugs at 2 x ED95 was confirmed to ensure a high-quality myorelaxation in different surgery variations (laparoscopy or laparotomy). A lack of effect on the hemodynamics (according to continuous non-invasive monitoring) and release of histamine (according to radioimmunology assay) make it possible to use the myorelaxants in patients with concurrent cardiovascular disease and with burdened allergic history. A bigger degree of prognosticated effect duration is typical of cisatracurium versus rocuronium, whereas the latter is a myorelaxant of choice in case a fast trachea intubation is needed.

Abdomen↗
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[Epidural block as a component of anesthesiological provision during abdominal operations].

Two modes of general anesthesia with artificial ventilation in combination with epidural block differing in a hypnotic component (inhalational or intravenous) were studied in 27 patients. A combination of general and epidural anesthesia afforded the best protection from surgical stress during major abdominal operations. Inhalational or intravenous anesthetics may be equally used to induce unconsciousness. The fact that there may be blood loss is not an absolute contraindication to epidural anesthesia. The safety and controllability of combined anesthesia increase when its individual components are monitored and the protocol is strictly observed. There is a need for further development of objective criteria for efficient regional block under general anesthesia.

Abdomen↗
PubMedDate not supplied

[Use of average-acting nondepolarizing myorelaxants in abdominal surgery].

The efficiency and safety of use of average-acting nondepolarizing myorelaxants, such as atracurium, vecuronuim, rocuronium, and cisatracurum, during abdominal surgical interventions under general anesthesia (combined or total intravenous anesthesia) were investigated in 162 patients. There is evidence that the use of the above agents ensures a qualitative myorelaxation during different types of operations (laparoscopic and laparotomic) and no impact on hemodynamics (according to the data of continuous non-invasive monitoring) allows these myorelaxants to be used in patients with concomitant cardiovascular diseases. Rocuronium is the myorelaxant of choice for rapid tracheal intubation. The high degree of predictability of the duration of an effect produced by atracurium and cisatracurium enables these myorelaxants to be used without monitoring neuromuscular conduction. With the equally good quality of myoplegia and with virtually comparable consumed diseases, the infusion procedure of relaxation maintenance is preferable for early activation of patients. Insignificant effects on histamine release make it possible to use vecuronium, rocuronium, and cisatracurium in patients with the compromised immune system.

Abdomen↗
PubMedDate not supplied

[Use of different types of target propofol concentration-control infusion: theoretical and practical aspects].

Examinations were made in 105 patients who had undergone total intravenous anesthesia on the basis of the immune circulating components (ICC) of propofol by different pharmacokinetic models--Marsh and Schnider, by aiming at plasma or an effector zone. Along with good controllability of ICC-anesthesia, with theoretical and practical differences of the employed models are shown. The capacities of an up-to-date universal perfusor are demonstrated, by using Asena PK as an example. Practical recommendations on its application are given. The prospects of anesthesia automation are briefly discussed.

Adult↗
PubMedDate not supplied

[Experience in the use of a benzodiazepine antagonist, flumazenil].

The efficacy of midazolam (0.071 +/- 0.006 microgram/kg) inactivation by flumazenil, a direct antagonist of benzodiazepines, was assessed in 20 patients during local and regional anesthesia. The hemodynamic values were assessed and a complex of psychological tests used. A single intravenous injection of flumazenil in a dose of 0.2 mg (2.8 +/- 0.41 micrograms/kg) resulted in a smooth an reliable arrest of benzodiazepine effect and effective repair of the main psychomotor reactions. Reversion of benzodiazepine effect is possible after an hour, which may require repeated injection of flumazenil.

Adult↗