Saratov JOURNAL of Medical and Scientific Research

Noskova I.L.

Saratov State Medical University n.a. VI. Razumovsky, Clinical Hospital n.a. S. R. Mirotvortsev, Anesthesiology and Resuscitation Department

Anaesthesiological maintenance in total endo-prosthesis of large joints

Year: 2013, volume 9 Issue: №2 Pages: 241-246
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Prigorodov М.V., Pominova I.V., Noskova I.L, Tashkaev I.V., Virsta A.M.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

Purpose: To improve the quality of anesthetic protection in prosthetics of large joints based on a steady state energy balance. Materials and methods: Prospective, randomized study on the basis of a controlled hemodilution (CM) double mask has been performed. In the first group of patients (32-19 women) hemodilution (HS) has not been done. The second group of patients (31-17) consisted of patients with HS. Three phases of the survey have been selected — before surgery, traumatic phase of the operation, after the operation. Analyzed the parameters of central hemodynamics (Cl (I/ min/m2) and total peripheral vascular resistance TPVR (dyn * sec1 * cm5), gas exchange (DO (ml / min) and V02 (ml / min), energy metabolism (kcal / min; kcal / day). For data processing statistical package STATISTICA6,0 was used. Results: Central hemodynamic parameters in both groups did not significantly change, and did not differ between the groups. A significant reduction in D02. DO differences between groups of patients at all stages of the studies found has been determined in both groups of patients. Oxygen consumption in the first group of patients decreased significantly to traumatic phase of the operation, and the next stage rose to baseline. Oxygen consumption in the group with CM increased by traumatic phase of the operation, but then returned to baseline. In patients with CM oxygen consumption was significantly higher than in patients without CM at all time points. It is found that there is a significant drop in energy metabolism in the first group of patients in traumatic phase of the operation, followed by reduction of the energy poten-
tial. It is noted that insignificant increase of energy on stage traumatic operation in the second group of patients, with a subsequent decrease to the original level. Energy exchange at all stages of the study was significantly higher in the second group of patients. Logistic regression analysis found that controlled hemodilution is associated with increased energy metabolism at the stage prior to surgery for traumatic stage and after the intervention. Conclusion: It has been established a connection with the growth of energy controlled hemodilution with radical intervention on the hip joint. Substantial energy deficit in patients without HS on traumatic phase of the operation reveals that the high probability of occurrence of cardiovascular complications.

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Influence of anaesthesia on energy metabolism in surgery

Year: 2013, volume 9 Issue: №1 Pages: 47-49
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Prigorodov М.V., Tashkaev I.V., Pominova I.V., Noskova I.L, virsta A.M.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

The purpose of the article is to establish adequacy of protection of energy metabolism in a patient under anaes-thesiology in cholecystectomy from mini-access. Material et methods: 122 patients subjected to cholecystectomy from mini access have been surveyed. Among them 92 patients have got intravenous general anaesthesia with AVL, 30 patients have got prolonged epidural anaesthesia on spontaneous breath with insufflations of oxygen through an obverse mask with sedatations. Monitoring of energy-plastic metabolism has been carried out in all patients. Results: Groups of patients have been compared by anthropometrical data, traumatic interventions. In both groups of patients loss of energy to traumatic to an operation stage has insignificantly increased, but after the anaesthesia termination in the group of patients with intravenous anaesthesia loss of energy continued to rise, and in the group of patients with prolonged epidural blockade it has returned to the initial level. After the anaesthesia termination the energy metabolism became essential higher in the first group of patients in comparison with the second one (p

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