[Violations of higher mental functions and their correction in patients undergoing video laparoscopic cholecystectomy under conditions of inhalation anesthesia with sevoflurane]. / Narusheniya vysshikh psikhicheskikh funktsii i ikh korrektsiya u bol'nykh, perenesshikh videolaparoskopicheskuyu kholetsistektomiyu v usloviyakh ingalyatsionnoi anestezii sevofluranom.

OBJECTIVE: To substantiate the advisability of using cytoflavin to correct postoperative cognitive dysfunction (POCD) in patients undergoing video laparoscopic cholecystectomy (VLCE) under conditions of inhalation anesthesia with sevoflurane. MATERIAL AND METHODS: The data of two representative groups of patients (n=60) who underwent video-laparoscopic cholecystectomy under the conditions of inhalation anesthesia with sevoflurane were analyzed. At the stages of the perioperative period, in order to monitor the state of higher mental functions, neuropsychological testing was performed: anxiety and depression scales (HADS), the Montreal scale of cognitive dysfunction (MoCA), and frontal dysfunction batteries (FAB). Patients of the first group (n=19) were not corrected for POKD. For the correction of cognitive impairment, patients of the second group (n=41) were treated with Cytoflavin according to the 20 ml regimen per 250 ml of 0.9% sodium chloride solution intravenously once before the operation, then within 4 days of the postoperative period. RESULTS: Neuropsychological testing in group I patients revealed the development of moderate POCD. The inclusion of Cytoflavin in the treatment regimen in the II group of patients contributed to an improvement in the state of HMF, accompanied by a decrease in the level of anxiety and depression. CONCLUSION: The inclusion of Cytoflavin in treatment regimens helps prevent the development of POKD and is accompanied by an improvement in the state of higher mental functions, which is manifested by a decrease in the level of anxiety and depression, favorably affecting the emotional background of patients.

[Analgesia of labor in women with diabetes mellitus].

UNLABELLED: The article deals with a study of duration of physiological labors in women with diabetes mellitus. PATIENTS AND METHODS: 120 women were devided into three groups according to method of analgesia. We assessed data of central haemodynamics, efficacy of analgesia, glucose level in blood, conditions of fetus and newborn. RESULTS: We found that epidural analgesia with bupivacaine hydrochloride was an optimal method of labor analgesia in women with diabetes mellitus. This method provided a stabilization of glucose level in blood, normalization of data of central haemodynamics and allowed to avoid anomalies of labor CONCLUSIONS: Analgesia with promedol and paracetamol is a preferable method in case of presence of epidural analgesia contraindications.