Introduction. Desflurane is the last inhalational anesthetic approved for use in the Russian Federation. The experience of its use in the country in comparison with sevoflurane is still not great for a number of reasons, including the insufficient volume of methodological literature in Russian. Objectives. To highlight the methodological aspects of the use of desflurane in modern anesthesiology. Materials and methods. The search for sources was carried out using the resources of the Russian scientific electronic library (eLIBRARY.ru), the bibliographic database of articles from the US National Library of Medicine (NCBI), the ClinicalKey electronic library, and the Scopus abstract and citation database. The search depth is 7 years. Results. A review of publications in 2014-2020, devoted to the methodology of using modern vapor-generating anesthetics, has been performed. The methodological techniques of anesthesia with desflurane are described in detail: inhalation induction, maintenance of anesthesia using a low and minimal flow of fresh gas, the peculiarities of the period of awakening and post-anesthetic rehabilitation are given. Conclusion. Desflurane is not the drug of choice for inhalation induction of anesthesia, but has a number of distinctive feature: advantages for using with low or minimal fresh gas flow; superiority in speed and predictability of the period of early post-anesthetic rehabilitation; safety of use, both in elderly patients and in children; relevance for Outpatient anesthesiology, Bariatric surgery, and programs for Enhanced Recovery After Surgery.
The objective: based on the published data to describe the conceptual issues of the problem of perioperative cardiac complications in non-cardiac surgery.Results: changes made to international guidelines over the past 3–4 years based on evidence-based studies and meta-analyzes have been analyzed. The article presents data on the etiopathogenesis of various postoperative cardiac complications, assessment of their risk based on the evaluation of functional activities of patients, cardiac risk indices, and modern biomarkers (B-type natriuretic peptides, cardiospecific troponins). The contemporary recommendations on adjuvant pharmacological cardioprotection and rational pharmacotherapy in the perioperative period are analyzed. The article describes specific parameters of diagnostic, treatment and prevention tactics in patients with coronary heart disease, hypertension, chronic heart failure, heart defects, and implanted electronic devices. It concludes that the implementation of the comprehensive strategy aimed at the reduction of risk of pulmonary complications should ensure the decrease in their frequency and mortality due to them.
The article deals with the problem of interrelation between the criminal sentence and resocialization of convicts. Data concerning the number of people returning to crime as well as people convicted on the judgement of guilt considering their prior convictions is analyzed with the view of identifying a way of influencing the level of recidivism through punishment assignment practice. The author justifies the idea of criminal punishment efficiency increase and criminal record improvement through ensuring a real opportunity for the convict to form a new social status after sentence completion. Resocialization as a complex multi-stage process should be launched at the stage of determining the type and amount of punishment for the guilty by the court. The analysis of penalties imposed on people with unexpunged or outstanding convictions enables the author to arrive at the conclusion about the necessity of setting the judges a special task of ensuring resocialization in order to achieve the goals of criminal punishment.
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