[Use of average-acting nondepolarizing myorelaxants in abdominal surgery].

The efficiency and safety of use of average-acting nondepolarizing myorelaxants, such as atracurium, vecuronuim, rocuronium, and cisatracurum, during abdominal surgical interventions under general anesthesia (combined or total intravenous anesthesia) were investigated in 162 patients. There is evidence that the use of the above agents ensures a qualitative myorelaxation during different types of operations (laparoscopic and laparotomic) and no impact on hemodynamics (according to the data of continuous non-invasive monitoring) allows these myorelaxants to be used in patients with concomitant cardiovascular diseases. Rocuronium is the myorelaxant of choice for rapid tracheal intubation. The high degree of predictability of the duration of an effect produced by atracurium and cisatracurium enables these myorelaxants to be used without monitoring neuromuscular conduction. With the equally good quality of myoplegia and with virtually comparable consumed diseases, the infusion procedure of relaxation maintenance is preferable for early activation of patients. Insignificant effects on histamine release make it possible to use vecuronium, rocuronium, and cisatracurium in patients with the compromised immune system.

[The immunological indices of patients with echinococcosis undergoing preoperative hemoexfusions]. / Immunologicheskie pokazateli u bol'nykh s ékhinokokkozom pri provedenii predoperatsionnykh gemoéksfuzii.

The immunologic parameters were studied in 38 patients with hydatid disease of the liver and abdomen before and after a single hemoexfusion (HE) in a volume of 400 ml. Among the patients who were examined there were those with uncomplicated hydatid disease of the liver (group I, second clinical stage, 25 persons), patients with suppuration of hydatid cysts (group 11, 10 persons), and two patients with multiple hydatid cysts complicated by their suppuration and calcification with involvement of large areas of the liver. Comparative analysis of immunological parameters in patients before and in the first 24 hours after HE showed a difference between the groups of patients and the controls. The parameters were restored to their initial values in patients of both groups 3-5 days after HE. The results of the study allow the conclusion that in screening patients with hydatid disease of the liver and abdominal cavity for preoperative HE a strict individual approach is necessary with the patient's general condition, the clinical form of the disease, and complications on the part of the cysts being taken into account.

[Change in catecholamine and acetylcholine concentration in myocardial tissue in assisted circulation]. / Izmenenie kontsentratsii katekholaminov i atsetikholina v tkani miokarda pri vspomogatel'nom krovoobrashchenii

The authors stress the importance of reactions associated with the concentration of biologically active substances in the body tissues, in particular their influence on the contractility and escitability of the heart muscle. They cite the results consequent upon a study on the catecholamines and acetylcholine content in the myocardial tissue of the left ventricle and left auricle of the heart before and after institution of an auxilliary circulation effected with the aid of a valveless pump connected to the subclavicular artery in 22 dogs. An analysis of the results demonstrated that by producing counter-pulsation with the pump the concentration of catecholamines and acetylcholine in the tissues of the left head diminishes, but the fall of the catecholamines concentration does not reach the level typical of cardiac insufficiency. The authors believe that investigations of this kind may help elaborate optimal conditions and a permissible duration of the auxilliary circulation.