“Difficult airways” situations continue to be one of the main causes of anesthetic mortality and morbidity. Current requirements of patient safety during anesthesia determine the need for the necessary equipment and compliance with existing clinical guidelines. The situation with the equipment of hospitals in the Russian Federation with different airway devices and medical equipment, as well as the approaches used by anesthesiologists are regularly reviewed by the FAR Committee of Difficult Airways by distributing a questionnaire. During the last 10 years there has been a positive trend in the level of hospital equipment with supraglottic airways, there has been an increase in the awareness of specialists about the existing clinical guidelines. An updated version of the survey was developed to examine the current situation in the Russian Federation, to analyze the effectiveness of the approaches used to solve the problem of “difficult airways” and to evaluate the role of the existing recommendations of the FAR. The role of the human factor is decisive in the development of a significant part of critical situations during anesthesia. A modern training program for clinical residents in anesthesiology should include training in upper airways assessment, performing basic maneuvers of airways management, working out techniques for using various devices, as well as using existing algorithms of actions during “difficult airways” situations. The ability to apply theoretical knowledge and act requires training in a high-fidelity simulation and subsequent analysis of residents performance. The newly developed survey is devoted to the analysis of the situation with airways management training in the clinical residency. Based on the results of the survey, it is planned to develop a draft national airways management training program for anesthesia residents.
Introduction. The problem of "difficult airways" will always remain relevant, since critical gas exchange disorders lead to the death or deep neurological disability of patients.
Introduction. Urogenital and anorectal functional disturbances associated with the pelvic autonomic nerve damage are common complications of rectal cancer surgery. the search for methods of intraoperative identification of the autonomic nerve plexus is currently one of the key tasks in modern surgery of rectal cancer. the purpose of our study is to evaluate the role of intraoperative neuromonitoring in rectal cancer surgery.Material and methods. In 2017 we performed intraoperative neuromonitoring during rectal cancer surgery in two cases. the superior hypogastric plexus and the inferior hypogastric plexus were identified and the pelvic autonomic nerve was preserved in both patients. urogenital and anorectal functional outcomes were assessed in the postoperative period.Results. Satisfactory functional outcomes in the late postoperative period and at the 12-month follow-up suggest that intraoperative neuromonitoring may be useful in identification and prevention of the pelvic autonomic nerve damage in patients with rectal cancer.Conclusion. This method would be difficult to use routinely for intraoperative identification of the autonomic nerve plexus but could be especially useful for the study of pelvic physiology. With further development, the method of intraoperative neuromonitoring could help discover a technique that will improve the surgical treatment of rectal cancer. Further research using intraoperative neuromonitoring is needed to more precisely determine its value in the preservation of urinary, anorectal and sexual function.
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