[Evaluation of efficacy and safety of optimized based on the ketamine modified neuroleptanalgesia during operations on the biliary tract and liver].

A comparative analysis of efficacy and safety of the neuroleptanalgesia (NLA) and balanced general anesthesia during operations on the biliary tract and liver. Analysis of the results of comprehensive studies of hemodynamic, humoral homeostasis, liver function and clinical anesthesia showed that the optimized on the basis of ketamine modified NLA provides effective neurovegetative protection during operations on the organs of the hepatobiliary system, accompanied by obscure variations in the studied parameters. Traditional methods of the modified NLA is characterized by insufficient anesthesia, accompanied by pronounced physical inactivity circulation and a large number of "critical incidents".

[Correction of homeostasis disorders in postoperative patients with disseminated purulent peritonitis]. / Korrektsiia narushenií gomeostaza v posleoperatsionnom periode u bol'nykh s rasprostranennym gnoínym peritonitom.

The results of the surgical treatment of 335 patients with a toxic stage of disseminated purulent peritonitis (DPP) are analysed. The toxic stage of the DPP is characterized by the pain syndrome, endotoxicosis, hypodynamic disorders of the blood circulation, respiration, and secondary immunodeficiency. The analgetic mixture of Analgin, Seduxen and No-Spa appeared to be more effective in pain relief than Promedol or Moradol. Slow body detoxication, long standing hypodynamic circulation disorders and immunodeficiency, high level of lethality (16.2%) are typical for patients with toxic stage of DPP treated with conventional therapy (infusion of desintoxic medicines, stimulated diuresis, peritoneal dialysis. The use of intravascular laser irradiation and hemosorption provides marked detoxic ating and immunostimulating effect. Hypoxia and circulatory hypodynamia and immunodeficiency are quickly eliminated with the use of hyperbaric oxygenation and immunocorrective medicines (T-activin, Decaris) and gives a chance to decrease mortality 2 times.

[Postoperative analgesia using moradol in emergency surgery]. / Posleoperatsionnoe obezbolivanie moradolom v neotlozhnoi khirurgii.

Moradol was used for postoperative analgesia in 39 patients subject to urgent surgery. Promedol was used as a control. It has been found that a marked pain syndrome in the early postoperative period in patients examined was characterized by certain deviations of the parameters studied. Moradol, as compared to promedol, has a better analgesic effect, causing milder respiration and hemodynamic changes. With intravenous drug injection, a more profound analgesia is associated with a greater respiratory depression.

[Preanesthetic preparation and induction anesthesia in acute cholecystitis in middle-aged and elderly patients]. / Prednarkoznaia podgotovka i vvodnyi narkoz pri ostrom kholetsistite u bol'nykh pozhilogo i starcheskogo vozrasta.

Under examination there were 59 elderly and senile patients with acute cholecystitis subjected to emergency operations. It was found that among 3 kinds of initial narcosis smooth course was notable in the phentanyl-sombrevin initial narcosis. The administration of thalamonal-sombrevin initial narcosis results in a certain inhibition of blood circulation, and gives adequate anesthesia during endotracheal intubation. The initial sombrevin narcosis is followed by inhibition of blood circulation and fails to give sufficiently deep anesthesia during intubation of the trachea.

[Hemodynamic function of patients with diffuse suppurative peritonitis]. / Sostoianie gemodinamiki u bol'nykh s razlitym gnoinym peritonitom.

A complex examination of central hemodynamics and contracting function of the heart was performed in 85 patients in the preoperative period. It was established that the toxic phase of peritonitis is characterized by the disturbed central hemodynamics and worse contracting function of the myocardium which are found to aggravate the process in the terminal phase and to require intensive prophylactic and curative measures. The authors consider that the shock index and coefficient of the functional state of central hemodynamics can be used in urgent cases for the assessment of the functional state of blood circulation.

[Basic principles of resuscitation and intensive therapy in patients with acute gastrointestinal hemorrhage]. / Osnovnye printsipy reanimatsii i intensivnoi terapii u bol'nykh s ostrym zheludochno-kishechnym krovotecheniem.

The authors analyze results of the treatment of 537 patients with acute gastro intestinal hemorrhages. All the patients were subjected to intensive therapy for the maintenance and recovery of vital functions of the organism. When the intensive therapy failed to give the necessary results the question was solved in favour of surgical interventions.