The effect of anesthesia on the neurohumoral regulation system and water-electrolyte balance during aortocoronary bypass

Two methods of multicomponent general anesthesia distinct in the analgetic agent used to ensure analgesia have been compared. In group I (6 patients) analgesia was ensured by fentanyl at a dose of 10 micrograms/(kg/min), in group II (7 patients) it was ensured by pyritramide (dipidolor) at a dose of 2 mg/kg for the whole operative period. The study has shown that during aortocoronary bypass surgery in patients with ischemic heart disease analgesia is better ensured by pyritramide than by fentanyl administration. The latter technique of analgesia should be improved, as the current modification causes almost twice as great stress-reaction as the one employing pyritramide.     

Changes in the cerebral blood flow in neurosurgical patients during general anesthesia using antihypoxic agents]

Cerebral blood flow (CBF) and central hemodynamics (CH) have been studied during anesthesia and after surgery in patients with tumours located in brain hemispheres. CBF and CH were determined by radiography. GOBA, diazepam and sodium thiopental were used for anesthesia. It has been shown that GOBA fails to normalize CBF both during and after surgery, diazepam normalizes blood flow in both brain hemispheres. Sodium thiopental leads to further CBF depression up to critical level in the affected hemisphere with parallel blood flow ingress in the intact brain hemisphere. It is concluded that the use of diazepam is advisable for anesthesia during surgery for tumours located in brain hemispheres.     

Spontaneous respiration during neurosurgical operations. I. Patients with brain stem pathology]

Spontaneous respiration (SR) was used for dynamic control of brain stem functions in 21 patients during excision of intramedullary tumours and brain stem hematomas. SR disturbances developed during tumour removal from caudal stem sections in 4 patients, in 2 of them the course of the postoperative period was severe. It seems expedient to include into the programme of intraoperation monitoring of patients operated on the brain stem the SR parameters for dynamic assessment of brain stem function.     

Experience with epidural anesthesia during myocardial revascularization operations

The paper presents the results of 213 myocardial revascularization using epidural anesthesia. The used anesthesiological protocol combining intravenous proforol sedation and epidural naropine block proved to be effective and safe and ensured adequate anesthesia that made possible myocardial revascularization both without using extracorporeal circulation (transmyocardial laser revascularization, mini-invasive myocardial revascularization) and with complex repairs of the geometry of the left ventricle and cardiac valvular apparatus and provides a means for the activation of patients and extubation on the operating table in the absence of surgical complications, hemorrhages, and extracorporeal circulation procedures even after reconstructive surgery.     

Regulation of sodium and water balance by the kidney

Maintenance of consistent internal environment is essential for mammalians to survive in waterless circumstances. Extracellular fluid (ECF) volume is maintained within a narrow range in normal humans, despite day-to-day variations in the dietary intake of salt and water. In general, kidneys are the major organs that play a predominant role in the control of the fluid and electrolyte balance. Recent advances in the molecular biology have provided significant contribution to the identification of kidney specific channels and transporters for sodium and water, leading to better understandings of the regulation of sodium and water balance. Generalized edema formation, a clinical hallmark of ECF volume expansion, represents the accumulation of excessive fluid volumes in the interstitial compartment and is invariably associated with renal sodium retention. In this article, we review the regulation of sodium and water balance in the kidney to understand the renal mechanisms of edema formation.     

Spontaneous respiration during neurosurgical operations. II. Patients with vascular pathology of the posterior sections of the circle of Willis]

Spontaneous respiration (SR) was retained during surgery in 17 patients with vascular pathology in the posterior sections of the circle of Willis (arteriovenous malformations of posterior cranial fossa, arterial aneurysm) to control brain stem function and preserve its blood flow. SR disturbances developed during the basic stage of the operation in 4 patients and were caused by the occlusion of various vessels in posterior sections of the circle of Willis. The control of SR parameters as part of intraoperation monitoring in patients with vascular pathology in posterior sections of the circle of Willis makes it possible to assess the retention of brain stem blood flow and thus to optimize surgical tactics.     

Epidural anesthesia during operations on the heart in patients with obesity

The paper estimates an anesthetic appliance using an epidural block during cardiac operations in obese patients. It shows the advantage of this type of anesthesia in reducing the dose of used narcotic analgesics, in early activating patients, and decreasing the length of stay in a cardiac intensive care unit.     

Drug dosage during balanced anesthesia in children with urinary tract diseases

To determine principles of choosing individual fentanyl and ketamin doses the data on the course of general anesthesia in 120 children were processed by regression analysis. It has been established that individual anesthetic dose titration should take into consideration the child's age, efficacy of premedication, renal function and circulatory pattern The infusion rate is determined with regard to anesthesia-induced circulatory changes. Regression analysis made it possible to work out formulas which enable individual dose titration and determination of the infusion rate.     

Results of intralaboratory quality control in the study of acid-base balance and water-electrolyte balance

Diagnosis of emergences is one of the important objectives of laboratory studies. The present views of critical states and of the modes of their correction make requirements for the quality of conducted studies and that of the apparatuses used in these studies. The present study was undertaken to determine the intra- and interseries reproducibility of the quality of measurement on a Rapidlab 800 gas analyzer (Bayer). The study has indicated that intra- and interseries quality control on the Rapidlab 800 gas analyzer (Bayer) complies with the requirements for the analytical devices used to study acid-base and water-electrolyte balances.     

Posterior spinal fusion with Harrington instrumentation using "balanced" anesthesia.

In our experience nitrous oxide-oxygen-morphine-curare anesthesia has proved preferable because of the need for swifly awakening patients after instrumentation to ascertain neurologic status. Adjunctively, doxapram has been used to awaken patients in a predictably short time span. To prevent massive blood loss, hypotension has been attained by pentolinium, trimethaphan camsylate, and sodium nitroprusside.