General anesthesia using calypsol during angiographic study of the extremities in children]

In 17 children aged 7 to 14 years angiography of the extremities (AGE) was performed under general anesthesia by intravenous calypsol injection without premedication with cholinolytics (group I, monoanesthesia) or with premedication with atropine and neuroleptics (diazepam, droperidol; group II). It has been established that calypsol, in both groups, had a short-term moderate stimulating effect on the cardiac function and an insignificant effect on the respiratory function, which was not essential for the assessment of hemodynamic parameters during AGE. Muscle relaxation was more marked in children of group II, mainly due to the use of neuroleptics. In children of group II muscle relaxation was insignificant, this was associated with certain difficulties during AG. A technique of calypsol anesthesia during AGE in children has been elaborated, it is recommended to use calypsol in combination with neuroleptics, and to strengthen anesthesia by additional calypsol administration prior to the injection of contrast agents.     

Variants of intravenous anesthesia during lung surgery in conditions of high-frequency artificial ventilation

Basic systemic hemodynamic parameters were compared during intravenous anesthesia with calypsol (ketamine) and diazepam, promedol and diazepam, fentanyl and diazepam, fentanyl and sombrevin in 120 patients operated on the lungs with conventional and high-frequency jet ventilation. The studies have shown that in conventional controlled lung ventilation there were no distinctions in hemodynamic parameters depending on the type of the anesthesia. In high-frequency jet ventilation, specific hemodynamic effects of calypsol were observed. Unlike other anesthetics, calypsol administration is associated with elevated central venous pressure, increased cardiac output and enhanced left ventricular work, which can be accounted for by higher venous return.     

The use of nitroglycerin in general anesthesia during vascular alloprosthesis

Glycerol trinitrate (GTN) was used during anesthesia in angiosurgical patients for the correction of vascular tone in initial hypertension, normalization of cardiac output and retention of compensatory vascular reactions in critical conditions of the circulatory system during inclusion and exclusion of the aorta from circulation. The combination of GTN with calypsol and narcotic analgesics reduces the hypertensive effect of calypsol and tachysystolic effect of GTN.     

Klofelin as a component of general anesthesia and a means of postoperative analgesia in cancer surgery

Clophelinum (0.0014 +/- 0.00007 mg/kg, intravenously) as a component of multicomponent general anesthesia eliminated hemodynamic and endocrine reactions during major abdominal and thoracic surgery in cancer patients, reducing the dosage of calypsol and fentanyl. In the postoperative period clophelinum in combination with Baralgin ensures effective analgesia without the use of any narcotic analgesics.     

The contractility of the lower portion of the esophagus as a criterion of the adequacy of anesthesia]

It has been found that narcotic analgesics (morphine, fentanyl and dipidolor), inhalation anesthetics (phthorothan and frilen) and an intravenous anesthetic calypsol suppress lower esophageal contractility. Comparison of lower esophageal contractility with hemodynamic parameters and ACTH and cortisol blood plasma content have revealed a direct correlation. It is concluded that the method of dynamic control over lower esophageal contractility may be an objective test controlling the adequacy of anesthesia during various surgical interventions.     

Non-inhalation anesthesia with preservation of spontaneous breathing in emergency surgery in children]

A total of 320 patients with acute abdominal surgical pathology were examined after general anesthesia with combined intravenous injection of sodium hydroxybutyrate and calypsol, with spontaneous respiration preserved. The examinations were performed under clinical control and impedance plethysmography. The combination of the above anesthetics has a lot of advantages over calypsol mono-anesthesia and ensures adequate blockade of visceral innervation. A slight circulatory hyperdynamia has been observed. This type of analgesia is one of the optimal methods of general anesthesia in children.     

The effect of calcium antagonists on pulmonary hemodynamics in patients with chronic bronchitis with manifest and latent pulmonary hypertension

Catheterization of the pulmonary artery and radiocirculography were used in 30 patients with chronic bronchitis (CB) in order to study changes in hemodynamics induced by intravenous injections of 5 and 10 mg verapamil or by 4-5 weeks of the treatment with finoptin and corinfar. Out of 47 studies, 22 (47%) showed a positive effect which was primarily recorded in patients (72%) suffering from apparent pulmonary hypertension (PH). The effect manifested itself in the form of a decrease in the total pulmonary resistance and/or in the mean pulmonary arterial pressure. In 13 cases (27%), the effect turned out negative. Meanwhile 12 cases (26%) demonstrated no effect at all. A beneficial effect was mostly recorded after administering 5 mg verapamil, whereas administration of 10 mg verapamil and prolonged use of finoptin and corinfar produced varied actions, with the negative effect being observed even more frequently as compared to the positive one. The pattern of the pulmonary hemodynamic response to a single intravenous injection of verapamil was also preserved in 60% of cases undergoing continuous treatment with finoptin and corinfar. Calcium antagonists can be used for the treatment of PH in patients suffering from CB. At the same time it is required that all the patients may be necessarily examined for hemodynamics.     

Liver blood flow during xenon anesthesia in surgical hepatology

The authors present their experience gained in anesthesias for resection of the liver. Methods for evaluating total liver blood flow by ueveredine dilution, portal blood flow by thermodilution, changes in arterial blood supply during and after the operation are discussed. Effects of methods of anesthesia on total liver blood flow and some parameters of systemic hemodynamics are analyzed. Effects of neuroleptanalgesia, ketamine and xenon anesthesia on liver blood flow are compared. The efficiencies of anesthesias for resection of the liver and their effects on liver function during and after the operation are evaluated. The results evidence that disorders in liver circulation parameters were far less pronounced in the patients operated on under Xe anesthesia in comparison with patients operated on under neuroleptanalgesia and calypsol anesthesia. The study confirmed a pronounced analgesic effect of xenon, and clinical results confirmed that Xe anesthesia can be used in traumatic interventions.     

Characteristics of general anesthesia in video thoracoscopic surgery in children

Videothoracoscopic operations were carried out in 54 patients aged 6 months to 14 years. Two variants of general anesthesia were used: bolus injection of fentanyl in combination with calypsol and infusion of fentanyl in combination with subnarcotic doses of fluothane. One-lung ventilation was carried out in all children. Hemodynamic status, gaseous composition of the blood, and cerebral bloodflow were monitored during general anesthesia.     

General anesthesia in patients with spontaneous respiration

Experimental studies performed on 97 alert rats and clinical studies in 930 cancer patients after extracavity surgery have demonstrated the advantage of the elaborated technique of total intravenous anesthesia of patients on spontaneous respiration with microdoses of diazepam, fentanyl, calypsol and droperidol over the current variants of inhalation and intravenous anesthesia with preserved spontaneous respiration. The technique elaborated is characterized by technical simplicity, efficacy, prompt postanesthetic rehabilitation of patients, safety for the personnel and economic benefits. The technique might be useful in mass injuries due to its minimum effect on the basic body functions and possibility of air breathing, with no special devices required.     

Effect of finoptin on systemic and cerebral hemodynamics in patients with early cerebrovascular disorders in arteriosclerotic stenosis of major arteries of the head

Blood Evans Blue dilution and ultrasound Doppler cardiography were used to examine systemic and cerebral hemodynamic changes after a single intravenous administration of finoptin (5 mg) and its course treatment (a daily dose of 120-240 mg) in 30 patients with initial signs of cerebrovascular insufficiency and 30 patients with transient cerebrovascular disorders in the presence of atherosclerotic stenoses of the cephalic great arteries. Finoptin was found to increase the linear velocity of blood flow mainly in stenotic arteries, without causing intracerebral steal. The agent also exerted a clear-cut cardiodepressive action which was levelled off by its vasodilating effect by the end of its course therapy.     

General anesthesia and ventilation of the lungs in endoscopic surgery of tumors of the larynx, trachea and bronchi]

Clinical study was carried out during 116 total anesthesias for endoscopic operations on the larynx, trachea, and bronchi. Multicomponent total anesthesia was based on fentanyl, calypsol, diprivane, and dormicum microdoses in combination with local lidocaine anesthesia of the airways and premedication with nonsteroid antiinflammatory drugs. Interventions on the larynx and proximal part of the trachea were carried out with the patients' spontaneous respiration retained; during interventions on the middle part of the trachea, forced ventilation of the lungs (FVL) was carried out through an intubation bronchoscope; and during total anesthesia for operations on the tracheal bifurcation, high-frequency FVL of the intact lung was carried out. Stable hemodynamics and gas exchange, hypercapnia, and moderate respiratory acidosis were observed in patients operated on under both types of FVL. No serious complications during and immediately after surgery and anesthesia were observed. Hence, the choice of the method of total anesthesia and ventilation of the lungs in endoscopic interventions on the airways depends on the level of lesions and degree of airway obstruction.     

Treatment of patients with transient disorders of cerebral circulation in occlusive diseases of major blood vessels of the head using vasoactive and cardiotonic drugs

Transient circulatory disorders of the brain arising in response to stenosis and occlusion of the major head arteries in 111 patients were treated with cardiotonic and vasoactive drugs (corglycon, strophanthin, sulfocamphocain, euphylline++, cavinton, finoptin). The treatment was controlled by monitoring systemic and cerebral hemodynamic parameters. An appreciable clinical response was achieved in more patients (by 16.3%) than it was usually the case in thus untreated patients.     

Anti-anginal effect of long-term use of obsidan, corinfar and finoptin in patients with stable exercise-induced stenocardia

Time course changes in antianginal effect were evaluated for obsidan, corinfar and finoptin under 12-week administration in 104 patients with stable angina pectoris. The response to finoptin appeared to rise while for obsidan and corinfar it was stable. Some patients with stable angina developed clinical tolerance to corinfar.     

Bispectral index (BIS)--a new ideology in solving an old problem

A new method of electroencephalogram (EEG) processing is discussed: bispectral index (BIS), used for monitoring the depth of total anesthesia. The technology of BIS estimation is a principally novel approach to EEG processing, which can be denoted as an expert conclusion. EEG monitor Aspect A-100 (Aspect Medical System, USA) has been used for 3 years in the operation room during narcoses with barbiturates, propofol, midasolam, fentanyl, calypsol, isoflurane, and nitric oxide. BIS is a convenient and reliable method for evaluating the depth of total anesthesia with anesthetics with pronounced hypnotic effects at all stages of surgery. The disadvantages of the method are enumerated. The authors claim that monitors designed for expert evaluations hold good promise.     

Comparative study of the effects of combined neuroleptanalgesia and epidural anesthesia on lipid peroxidation

A comparative study of the impact of neuroleptanalgesia (NLA) and epidural anesthesia on lipid peroxidation (LPO) in the blood plasma and erythrocyte membranes has demonstrated that NLA has a more marked inhibitory effect on LPO. This type of anesthesia is characterized by effective protection of erythrocyte membranes, with intraoperative hemodynamic effects less expressed.     

七氟醚麻醉对降低肝癌患者术后恶心呕吐发生率的临床观察

目的探讨七氟醚麻醉降低肝癌患者术后恶心呕吐发生率的效果。方法选取80例肝癌患者,将其随机分为七氟醚麻醉组（A组）和异氟醚组（B组）,每组各40例。常规麻醉诱导后,A组麻醉维持用2%～3%七氟醚吸入麻醉,B组给予1.0%～1.5%异氟醚吸入。观察两组患者麻醉诱导后血压、心率变化、苏醒时间、术后疼痛、恶心呕吐情况。结果血流动力学变化平稳检测中A组血流动力学变化较平稳,优于B组（P〈0.05）,术后苏醒时间检测上A组短于B组（P〈0.05）;术后恶心呕吐情况检查上A组呕吐情况较少,优于B组（P〈0.05）,术后疼痛两组比较差异无统计学意义（P〉0.05）。结论七氟醚维持全静脉麻醉用于肝癌手术中麻醉平稳,血流动力学变化平稳,术后苏醒较快,术后恶心呕吐较少。     

经皮穴位电刺激对七氟醚轻麻醉下应急反应的影响

40例择期手术患者 ,随机分组观察吸入 1MAC七氟醚麻醉切皮时 ,加用HANS电刺激仪连续刺激一侧合谷穴 ,观察对血流动力学和定量脑电图的影响。结果表明电刺激一侧合谷穴可以减轻吸入 1MAC七氟醚麻醉切皮时产生的心血管应急反应 ,而定量脑电图的变化不明显。     

不同麻醉方式对子痫前期剖宫产术中产妇血流动力学影响

目的探讨气管内插管全身麻醉、蛛网膜下腔阻滞麻醉对子痫前期剖宫产术的麻醉效果及对产妇血流动力学和母婴结局的影响。方法选取2016年1月至2019年6月子痫前期产妇86例,随机分为全身麻醉组(A组)和蛛网膜下腔阻滞麻醉组(B组),各43例。比较两组产妇麻醉效果、起效时间、围术期血流动力学变化及母婴结局。结果A组产妇麻醉起效时间短于B组(P<0.05);两组产妇麻醉效果优良率比较,差异无统计学意义(P>0.05)。两组产妇不同时间点SBP、DBP、HR不同程度降低,与T0比较,差异有统计学意义(P<0.05)。在T1、T2、T3、T4时间点,A组SBP、DBP水平明显高于B组(P<0.05);两组产妇HR水平在T2~T5时间点比较,差异有统计学意义(P<0.05);两组产妇SpO2水平在T0~T5各时间点比较,差异无统计学意义(P>0.05)。两组产妇不同时间点MAP不同程度降低,与T0比较,差异有统计学意义(P<0.05);T1、T4、T5时间点血流动力学指标比较,差异有统计学意义(P<0.05);两组产妇SpOz水平在T0~T5各时间点比较,差异无统计学意义(P>0.05)。两组产妇产后出血量和术中低血压发生率比较,差异无统计学意义(P>0.05);与A组比较,B组产妇术后头痛发生率较A组增高,但差异无统计学意义(P>0.05)。两组胎儿娩出后1 min,5 min Apgar评分比较,差异无统计学意义(P>0.05)。结论子痫前期产妇在行剖宫产术时,全身麻醉与蛛网膜下腔阻滞麻醉同样安全、有效,全身麻醉麻醉起效更快,对产妇血流动力学影响更小,且两种麻醉方法对新生儿Apgar评分均无明显不良影响,可有效保证母婴安全。     

腰硬联合麻醉对肾移植手术患者围术期血流动力学的影响

【目的】探讨腰硬联合麻醉下肾移植手术受体围术期血流动力学变化规律。【方法】随机选择100例肾移植术患者,在腰硬联合麻醉下行同种异体肾移植手术,观察其血流动力学的变化。【结果】腰硬联合麻醉后10 min收缩压（SBP）、平均动脉压（MAP）、舒张压（DBP）明显下降（ P ＜0．05）,阻断髂静脉20 min后SBP、MAP、DBP逐渐恢复到麻醉前水平,移植肾血流开放后SBP、DBP、MAP明显下降。【结论】腰硬联合麻醉用于肾移植手术效果理想、确切;其对血流动力学影响在不同手术阶段有不同的变化,控制平稳的关键在于各阶段的麻醉处理是否得当。