14 research outputs found
Malignant hyperthermia (literature review)
No full textThe objective – to summarize the current literature data on the etiology, pathogenesis, diagnosis and treatment of malignant hyperthermia. The search and analysis of literature data on malignant hyperthermia in the medical information systems PubMed, Сochrane librarу, Cyberleninka for the last 10 years was performed with using the keywords: «malignant hyperthermia», «dantrolene», «general anesthesia», «succinylcholine», «inhalation anesthetics». The search criteria were met by 96 publications. In addition, references to selected articles were manually checked for applicable articles including recent reports of malignant hyperthermia, in addition to works of historical significance. It was shown that malignant hyperthermia develops in susceptible individuals during or after general anesthesia with the use of trigger agents – inhaled halogen-containing anesthetics and succinylcholine. Until recently, the problem of treatment in Russia remained unresolved, since specific therapy for this syndrome was not available. In connection with the official registration of Dantrolene in the Russian Federation, this problem no longer has a life-threatening potential. Doctors should recognize the symptoms of this disease as early as possible in order to quickly begin the pathogenetic treatment of malignant hyperthermia in order to prevent fatal complications. The material is intended for a wide audience of anesthesiologists, resuscitators and surgeons who may encounter this pathology in clinical practice
Retrobulbar blockade during eyeball enucleation surgery in children with retinoblastoma
No full textRetinoblastoma (RB) is a malignant tumor of the embryonic nerve retina.Purpose. To determine the effectiveness of retrobulbar blockade (RbB) with ropivacaine 0.5% for intra- and postoperative analgesia, as well as for the prevention of oculocardial reflex (OCR), postoperative nausea and vomiting (PONV) during enucleation.Material and methods. A prospective randomized controlled clinical trial was performed. Eighty patients aged 0 to 10 years were included, who were randomly assigned to the RbB group (retrobulbar blockade with ropivacaine 0.5% with general anesthesia) (n=40) and the GA control group (general anesthesia) (n=40).Results. There were no complications in the RbB group caused by the methodology. In the intraoperative period, the average dose of fentanyl in the RbB group was 4.7±0.7 μg/kg, which is significantly lower than in the OA group of 10.1±1.9 μg/kg (p<0.05). OCR in the RbB group was observed in 5% of cases versus 100% in the GA group (p=0.002). The average VAS score was 1.8 vs. 3.7 60 minutes after surgery (p<0.001). For the first time 12 hours after surgery, PONV was not observed in the RBB group, and in the control group it was observed in 45% of patients.Conclusion. The study revealed that intraoperative retrobulbar blockade with 0.5% ropivacaine solution in children with RB is effective and safe. Provides stable intraoperative hemodynamics and reduces the need for opioids. Promotes the prevention of OCD and PONV, as well as the improvement of postoperative analgesia during the operation of enucleation of the eyeball i n pediatric
Thoracic Paravertebral Block for Postoperative Analgesia in Pediatric Oncology
No full textObjective: to enhance the efficiency and safety of anesthesia during thoracic surgical interventions in pediatric cancer surgery, by using general anesthesia in combination with thoracic paravertebral analgesia.Subjects and methods. A prospective, randomized trial was conducted. Intra- and postoperative data were analyzed in 90 patients who had been operated on for lung and thoracic malignancies. There were two patient groups: 1) 50 children who used continuous thoracic paravertebral block (PVB) with ropivacaine 0.3% as part of combined balanced anesthesia and 2) 40 children who received epidural block with ropivacaine 0.2% as an analgesic component of combined anesthesia. All the patients underwent hemodynamic monitoring; postoperative pain assessment were carried out by a visual analogue scale (VAS) in children above 3 years of age and by the modified Douleur Aigue du Nouveau-ne (DAN) scale in those below the age of 3 years.Results. The trial has demonstrated that the analgesic effect during continuous PVB in the intra- and postoperative periods is comparable with that of epidural block with ropivacaine 0.2%; however, it has a higher hemodynamic stability. Ultrasound guided PVB has sufficient safety. The postoperative complications were pneumonia in 2 (4%) patients in the PVB group; these were associated with the baseline patient status in 5 (12.5%) children in the epidural analgesia group. Postoperative nausea was found in only 6% of the patients in the PVB group.Conclusion. The proposed modification of ropivacaine 0.3% injection into the paravertebral space under ultrasound guidance can increase the extent of the local anesthetic, thus enhancing the efficiency of PVB. The efficiency of the block is 98.1% versus 86% of the given by foreign authors
TCSR Features Ensuring the Prevention of Voltage Resonance During Power Transmission Line Single Phase Auto-Reclosing
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