RESUMO
Comparative study of postoperative analgesia and sedation with trimeperidine and dexmedetomidine and their effects on haemodynamics and vegetative nervous system was performed. Assessment of analgesia and sedation during vagotonia (first part of the study) and hypokinetic type of haemodynamics (second part of the study) was carried out with visual analogue scale (VAS) and Richmond scale. Results of the study showed that dexmedetomidine is more effective and safer than trimeperidine for analgesia and sedation in patients with spontaneous breathing after abdominal surgery. Dexmedetomidine use allows keeping optimal type of haemodynamics and vegetative nervous system parameters on first day of postoperative period.
Assuntos
Abdome/cirurgia , Analgésicos não Narcóticos/uso terapêutico , Dexmedetomidina/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Receptores Adrenérgicos alfa 2/metabolismo , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/efeitos adversos , Sedação Consciente/métodos , Dexmedetomidina/administração & dosagem , Dexmedetomidina/efeitos adversos , Hemodinâmica/efeitos dos fármacos , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/efeitos adversos , Dor Pós-Operatória/metabolismo , Sistema Nervoso Parassimpático/efeitos dos fármacos , Promedol/administração & dosagem , Promedol/efeitos adversos , Promedol/uso terapêutico , Resultado do TratamentoRESUMO
The paper describes the experience in using three predictive criteria, such as Mallampati test, Patila test, and ULBT test, to evaluate tracheal intubation and compares their predictive validity. The experience in applying Macintosh and Truview laryngoscopes to patients with predicted difficult tracheal intubation (DTI) is also depicted. A combination of three above predictive procedures is a reliable predictor of DTI (r = 0.5; p < 0.05). Therefore their combination may be recommended for clinical use to predict DTI. No significant correlation was obtained between the other criteria of DTI and the difficulties during intubation at the first attempt (p > 0.05). There was no statistical significant correlation between the used type of a laryngoscope and the rate of effective/ineffective intubations at the first attempt (r = 0.34; p > 0.05).
Assuntos
Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Laringoscópios , Lábio , Desenho de Equipamento , Humanos , Registro da Relação Maxilomandibular/métodos , Lábio/anatomia & histologia , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
The review covers the history of neuromuscular block reversal. It states that indications for decurarization have been changed due to the extremely high rate of residual curarization even after the use of average-acting myorelaxants. The paper provides the pharmacological characteristics of sugammadex, a new selective relaxant-binding agent for aminosteroids (rocuronium and vecuronium) with the unique mechanism of action. It also gives data on the efficacy and safety of sugammadex versus anticholinesterase agents and estimates the prospects for its clinical application.
