RESUMEN
The rationale for cost-effectiveness of modern muscle relaxants (MR) administration in general anesthesia was evaluated. New MRs are more expensive than traditionally used pipecuronium and succinylcholine. However, the old MRs are often required as a block reversion with anticholinesterase medicines at the end of surgery, the longer artificial lung ventilation and observation in patients during recovery in intensive care unit. It was found that the district military hospital had done an annual average of about 900 general anesthesia assisted with artificial ventilation and muscle relaxation. About 2% of all anesthesias accrue to short-term anesthesia, the 27% to medium-term and 71% to long-term. 81% of the medium-term anesthesia accrue small hospitals. According to cost/effectiveness the most optimal muscle relaxants administration scheme for short-term (up to 30 min) anesthesia was mivacurium, for the operation of medium duration (30-120 min)--rocuronium, for long-term (120 min)--pipecuronium. An electronic form of annual report, which allows to obtain the necessary data for calculation of annual muscle relaxants demand and costs both in hospital and in the whole of the armed forces quickly, was developed.
Asunto(s)
Anestesia , Revisión de la Utilización de Medicamentos , Hospitales Militares , Isoquinolinas , Fármacos Neuromusculares no Despolarizantes , Anestesia/economía , Anestesia/métodos , Análisis Costo-Beneficio , Hospitales Militares/provisión & distribución , Humanos , Isoquinolinas/administración & dosificación , Isoquinolinas/economía , Mivacurio , Fármacos Neuromusculares no Despolarizantes/administración & dosificación , Fármacos Neuromusculares no Despolarizantes/economía , Federación de RusiaAsunto(s)
Anestesia/métodos , Servicios Médicos de Urgencia/métodos , Medicina Militar/métodos , Personal Militar , Resucitación/métodos , Guerra , Heridas y Lesiones/terapia , Afganistán , Anestesia/estadística & datos numéricos , Urgencias Médicas , Servicios Médicos de Urgencia/estadística & datos numéricos , Humanos , Medicina Militar/estadística & datos numéricos , Personal Militar/estadística & datos numéricos , Resucitación/estadística & datos numéricos , Federación de RusiaRESUMEN
The article summarizes the experience of reanimation care to the wounded in Afghanistan, analyses intensive care requirements, as well as the frequency of application of its methods, determines the contents of emergency medical care in the course of treatment in intensive care units. The author has his own opinion concerning the principles of reanimation care management at evacuation phases in cases of mass casualty admission during "major" war.