Saratov JOURNAL of Medical and Scientific Research

Panov V.A.

Military Medical Academy n.a. S. M. Kirov, Department of Anesthesiology and Reanimatology

Evaluation of latent period of temperature sensitivity in traditional and unilateral spinal anesthesia

Year: 2015, volume 11 Issue: №3 Pages: 263-267
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Lakhin R.E., Panov V.A., Schegolev A.V., Kuligin A.V.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Objective: evaluation of the differences in the level of temperature, sensory and motor blockade during the various techniques of spinal anesthesia. Materials and Methods. Prospectively the randomized study included 70 patients. In the group with conventional spinal anesthesia (n=35) 15mg of bupivacaine injected quickly. In the group with unilateral spinal anesthesia (n=35) 7.5mg of bupivacaine administered slowly, at a rate of 1 ml per minute. We studied the level of temperature and time, sensory and motor blockade. The data are statistically processed. Results. Reduced thermal sensitivity recorded in an average of 48 seconds as a unilateral spinal anesthesia group and the control group. Subarachnoid administration of 7.5 mg of hyperbaric bupivacaine resulted in the development of a complete motor blockade underlying lower extremity in only 16 patients (45.7%). Conclusion. Using lower dosages of bupivacaine for unilateral spinal anesthesia lowers the threshold concentration of the local anesthetic in the subarachnoid space, resulting in slower motor neuron blockade and it is not total in more than 50% of cases.

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Low dose spinal anesthesia for knee arthroscopy

Year: 2015, volume 11 Issue: №2 Pages: 126-128
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Lakhin R.E., Schegolev A.V., Panov V.A., Kuligin A.V.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

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Assessment of efficiency of the strengthening mode of ultrasonic visualization of needles for peripheral regional anaesthesia

Year: 2014, volume 10 Issue: №4 Pages: 612-616
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Kuligin A.V., Panov V.A., Lakhin R.E., Shchegolev A.V., Yatsenko D.V., Kotikova M.N.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Research goal: optimization of peripheral regional anaesthesia under ultrasound. Material and Methods. Study has been performed by SonoSite Edge (SonoSite, Bothell, США) on a lineal transducer machine for fixed terms 38-mm (13-6 MHz) of overall gain and depth. The study included 2 sonographic needles and 2 non-sonographic needles. Ultrasound images were obtained and analyzed by an experienced anaesthesiologist. Results. In this study improved ultrasound imaging needle for peripheral regional anaesthesia using technology SonoMBe compared with a conventional scanning mode has been demonstrated. Conclusions. SonoMBe technology increases the echogenicity of needles for peripheral regional anaesthesia that allows the use of this technology gain in the performance of nerve block and plexus block anesthesia

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