RESUMEN
OBJECTIVE: To study the dynamics of markers of brain damage, determine their role in postoperative cognitive dysfunction (POCD) and evaluate the effectiveness of therapeutic correction of POCD in patients undergoing laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane. MATERIAL AND METHODS: We analyzed data of two representative groups of patients (aged 55 years and older) who underwent laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane. Perioperative neuropsychological testing was performed for monitoring of higher mental functions (MoCA and FAB). In the 1st group (n=30), POCD was not corrected. In the 2nd group (n=30), Cellex 0.1 mg was subcutaneously injected once before surgery and then throughout 5 postoperative days to correct cognitive disorders. RESULTS: Neuropsychological testing revealed moderate POCD in the 1st group. In the 2nd group, Cellex provided a significantly lower level of brain-specific proteins compared to the 1st group. This limited brain damage and ensured no severe cognitive deficit in early postoperative period. CONCLUSION: Laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane in patients aged 55 years and older is accompanied by moderate POCD in early postoperative period. Injections of Cellex 0.1 mg before surgery and then for 5 postoperative days prevent POCD and improve quality of life.
Asunto(s)
Anestésicos por Inhalación , Colecistectomía Laparoscópica , Disfunción Cognitiva , Anestesia por Inhalación/efectos adversos , Anestésicos por Inhalación/efectos adversos , Colecistectomía Laparoscópica/efectos adversos , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Humanos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Calidad de Vida , Sevoflurano/efectos adversosRESUMEN
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.
Asunto(s)
Anestésicos por Inhalación/efectos adversos , Colecistectomía Laparoscópica , Trastornos del Conocimiento/terapia , Mononucleótido de Flavina/administración & dosificación , Inosina Difosfato/administración & dosificación , Fármacos Neuroprotectores/administración & dosificación , Niacinamida/administración & dosificación , Sevoflurano/efectos adversos , Succinatos/administración & dosificación , Anestesia por Inhalación/efectos adversos , Anestesia por Inhalación/métodos , Colecistectomía Laparoscópica/efectos adversos , Colecistectomía Laparoscópica/métodos , Trastornos del Conocimiento/inducido químicamente , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Combinación de Medicamentos , Humanos , Cirugía Asistida por VideoRESUMEN
The results of genetic and demographic study of the inhabitants in south Tadjikistan are presented. It had been shown that the population studied is a typical rural population of Middle Asia and is characterized by the extended reproductive capacity, homogeneity of national composition and a high proportion of consanguineous marriages. Genetic variation in blood groups (AB0, MN, Rh-D, P1), serum proteins and red cell enzyme systems (Tf, Gc, Hp, PGM1, PGD, EsD, AcP1) was examined. A comparative analysis of gene frequencies in the population studied and some other Middle Asia populations has been carried out.