Objective : to carry out comparative assessment of effectiveness of different techniques of combined anesthesia in surgical correction of congenital disorders of the urinogenital system by means of the analysis of changes of integrative hemodynamic parameters. Material and methods . 116 patients were divided into 3 clinical groups depending on the type of ananesthetic aid. In the first group (40 patients), surgeries were performed under multicomponent balanced inhalation anesthesia, in the second group (42 patients) - under common inhalation anesthesia in combination with caudal blockade with solution of local anesthetic and patients of the third group (34 patients) were operated under common inhalation anesthesia with caudal blockade with solution of local anesthetic and an adjuvant.The calculation of the integrative hemodynamic parameters at 8 surgery stages (K-1 and K-2) was made for different techniques of anesthesia. Results. We have revealed statistically significant differences in the studied parameters of hemodynamics at certain stages of the perioperational period corresponding to the beginning of the surgery and its most traumatic stage in both the clinical groups, which reasoned in favor of more efficient blockade of painful sensitivity in the application of caudal analgesia. The technique of combined anesthesia with application of the combination of local anesthetic solutions and an adjuvant during surgical correction of congenital disorder of the urinogenital system in children has appeared to be the most efficient and adequate, which has been indicated by the studied hemodynamic parameters.
Objective: to assess the efficiency and safety of an anesthetic technique during the surgical correction of congenital malformations of the lower departments of the urogenital system in children by means of the comparative analysis of laboratory and hemodynamic indices, as well as the course of the early postoperative period, development of adverse effects during the anesthesia.Material and methods. Depending on the type of anesthesia, all patients (127 boys) were divided into 3 clinical groups: those operated under multicomponent balanced inhalation anesthesia (group 1, n = 37), under general laryngeal mask anesthesia in combination with caudal blockade with a local anesthetic solution (group 2, n = 45), under general laryngeal mask anesthesia with caudal blockade with the combination of a local anesthetic solution and adjuvant (group 3, n = 45).Results. The performed analysis of the parameters of hemodynamics, levels of cortisol, glucose, lactate and interleukin-6 (IL-6), as well as the quality, duration, depth of anesthesia and the necessity for an inhalation anesthetic, the assessment of complications and the adverse effects have revealed statistically significant differences indicative of a more effective blockade of the pain sensitivity in the combined application of general and regional anesthesia.Conclusion. The technique of combined anesthesia with the application of the combination of 0.25 % bupivacaine solution and adjuvant to 0.1 % morphine has shown the best efficiency and safety during the surgical correction of congenital malformations of the lower departments of the urogenital system in the children.
Objective: to identify the most effective and safest anesthesia technique for prostate puncture biopsy by means of the comparative analysis of the parameters of hemodynamics, postoperative motor block, and anesthesia, as well as the patient's subjective assessment of the quality of anesthesia. Material and methods: 30 male patients were divided into 2 clinical groups depending on the anesthesia technique. In the 1st group (15 patients), puncture biopsies (BP) were done under saddle spinal anesthesia, in the 2nd group (15 patients) - with the application of traditional spinal anesthesia (SA). The comparative analysis of hemodynamic indices, motor block, the efficiency of anesthesia and the patient satisfaction with the quality of anesthesia was performed. Results. No statistically significant difference between the hemodynamic indices, intraoperative anesthesia and subjective assessment of the quality of anesthesia by the patients was revealed, but at the same time the comparison of the postoperative motor block between the study groups found some statistically significant differences.
Vipera berus is the only venomous snake living in Belarus. Poison of a viper has a hemorrhagic and necrotizing effect. As a result of the poisoning with these poisons, hemorrhagic hypostases, blood clotting disorders, and destruction of tissues develop, which can lead to multiple organ dysfunction syndrome or even a fatal outcome. It is extremely dangerous when a viper bites a person into the area of the heart or neck. If medical aid is not provided in time, the person may die of suffocation as the edema on the neck will weigh upon the trachea [1, 2]. The article presents the observation of clinical cases of MODS development in children after a viper`s bite and the favorable outcome after performing a course of intensive care at ICU Gomel Regional Clinical Hospital.
The article presents a case of a baby born at the Gomel Regional Clinical Hospital in 2013. The baby, born at the Gomel Regional Maternity Hospital had surgery according to life indications, severe blood loss, hemorragic shock, disseminated intravascular clotting and syndrome of multiorgan disfunction. The patient later developed a large catheter-associated trombus of the right atrium with pulmonary embolism. [1, 2, 3, 5]. We did not have any clinical experience on trombolytic therapy in newborns after hemorragic shock. We could not find any standard recommendations, descriptions of similar cases in information resources. The newborn received a recombinant tissue plasminogen activator and later we removed the central venous catheter with the remains of the trombus. The trombolysis with the recombinant tissue plasminogen activator was successful and without any complications. The baby survived and was discharged from the hospital.
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