ABSTRACT
In this article, we consider the influence of combined general anesthesia on the results of electrically-involved stapedial reflex threshold (esrt) registration. We pay a special attention to the anesthesia to exclude its influence on the esrt. This study included 52 patients with bilateral chronic neurosensory hearing impairment. We conducted a retrospective (from 2014 to 2016) and prospective (from 2017 to 2018) analysis of anesthesia protocols. Even though the inhaled anesthesia (sevoflurane in this case) has a depressive effect on esrt registration (the higher the minimal alveolar concentration of anesthetic agent, the higher the reflex threshold), our study shows a possibility of using it in an extended anesthesia monitoring. Inclusion of myorelaxants in cochlear implantation anesthesia protocol not only provides a safe anesthesia, but also does not prevent a timely intraoperative cochlear implant testing.
Subject(s)
Cochlear Implantation , Cochlear Implants , Anesthesia, General , Electric Stimulation , Humans , Prospective Studies , Reflex, Acoustic , Retrospective StudiesABSTRACT
The article deals with data of cerebral oximeter INVOS Somanetics (US) used for comparison the degree of brain oxygenation reduction, ejection fraction and stroke volume relative to age norms in children with dilated cardiomyopathy.
Subject(s)
Cardiomyopathy, Dilated/metabolism , Cerebral Cortex/metabolism , Cerebrovascular Circulation/physiology , Oxygen Consumption/physiology , Adolescent , Body Temperature/physiology , Body Weight/physiology , Carbon Dioxide/blood , Cardiomyopathy, Dilated/blood , Cardiomyopathy, Dilated/diagnostic imaging , Cardiomyopathy, Dilated/physiopathology , Child , Child, Preschool , Echocardiography , Hemoglobins/analysis , Humans , Infant , Oximetry , Oxygen/bloodABSTRACT
The advantages and disadvantages of intravenous and inhalation anesthesias in pediatric anesthesiology are analyzed. Causes of complications induced by myorelaxants and measures for preventing these complications are discussed. Basic protocols of intravenous or inhalation anesthesias with the minimum fresh gas flow for pediatric anesthesiology are presented.
Subject(s)
Anesthesia, Inhalation/statistics & numerical data , Anesthesia, Intravenous/statistics & numerical data , Child, Preschool , Humans , Neuromuscular Agents/administration & dosage , Practice Patterns, Physicians'Subject(s)
Hepatitis, Viral, Human/therapy , Hypertension, Portal/complications , Liver Cirrhosis/therapy , Plasmapheresis , Adolescent , Child , Chronic Disease , Female , Hepatitis, Viral, Human/complications , Hepatitis, Viral, Human/surgery , Humans , Liver Cirrhosis/complications , Liver Cirrhosis/surgery , Male , Preoperative Care , SyndromeABSTRACT
The urgent porto-system bypass has been used in 26 children with portal hypertension to prevent acute gastro-esophageal bleeding. This method may be used in all types of portal circulation blockade. The bleeding stopped within first two postoperative days and there were no cases of its relapse within 6 years.
Subject(s)
Gastrointestinal Hemorrhage/prevention & control , Hypertension, Portal/complications , Hypertension, Portal/surgery , Portasystemic Shunt, Surgical , Adolescent , Child , Child, Preschool , Gastrointestinal Hemorrhage/etiology , Humans , Infant , Portasystemic Shunt, Surgical/methods , Retrospective Studies , Treatment OutcomeABSTRACT
Intraoperative examinations of 15 patients with extrahepatic portal hypertension carried out to elucidate the effect of pituitrin infusion on the central and portal hemodynamics and analysis of the clinical results of treatment of gastroesophageal hemorrhages with pituitrin infusions in 17 patients showed that infusions of pituitrin solution were sufficiently effective in this patient population. The drug exerted the minimal effect on the central hemodynamics and appreciably improved the portal pressure and bloodflow.
Subject(s)
Esophageal and Gastric Varices/complications , Gastrointestinal Hemorrhage/etiology , Hypertension, Portal/drug therapy , Pituitary Hormones, Posterior/therapeutic use , Adolescent , Child , Child, Preschool , Gastrointestinal Hemorrhage/drug therapy , Hemodynamics , Humans , Hypertension, Portal/physiopathologyABSTRACT
Central hemodynamics, blood gas composition, portal blood flow, and hepatic function have been studied in 30 children with extrahepatic portal hypertension during various types of intraoperative anesthesia. Neuroleptanalgesia and combined halothane and calypsol anesthesia ensure an adequate patient protection from surgical trauma. Each type of anesthesia has its specific effect on portal blood flow. This type of surgical interventions is characterized by frequent use of blood transfusions. According to the data of histochemical and biochemical studies all types of anesthesia have an equal effect on the liver.
Subject(s)
Hypertension, Portal/surgery , Portacaval Shunt, Surgical , Adolescent , Anesthesia , Blood Transfusion , Child , Child, Preschool , Female , Hemodynamics , Humans , Hypertension, Portal/physiopathology , Infant , Liver Circulation , Liver Function Tests , Male , Neuroleptanalgesia , Postoperative Complications/prevention & control , Premedication , Risk FactorsABSTRACT
In the present study alpha 1-adrenergic receptors have been investigated in liver parenchyma, obtained at the resection of prehepatic portal hypertension children without parenchymal affection (control group, n = 7) and the resection of children in parenchymal affection (group of cirrhosis, n = 8). It has been shown, that the binding of alpha 1-adrenergic antagonist 3H-prasozin (3H-PRZ) in liver parenchyma membranes of both control and cirrhosis groups is saturable and shows a high affinity. The Scatchard analysis of the binding data indicated that the binding site is characterized by Kd and Bmax of 0.6 +/- 0.12 nM, 92.8 +/- 8.0 fmol/mg, respectively, for the control group; and 1.5 +/- 0.4 nM, 254.1 +/- 28.4 fmol/mg, respectively, for the group of cirrhosis; (mean +/- SEM). It has been found that the number of binding sites of 3H-PRZ significantly increases in cirrhosis liver parenchyma in comparison with the control group. The results obtained suggest that alpha 1-adrenergic receptors play an important role in cirrhosis formation in children, showing liver parenchyma affection severity and its regenerative properties.
Subject(s)
Liver Cirrhosis/metabolism , Liver/chemistry , Receptors, Adrenergic, alpha/analysis , Adolescent , Biopsy , Child , Child, Preschool , Humans , Hypertension, Portal/metabolism , Hypertension, Portal/pathology , Liver/pathology , Liver Cirrhosis/etiology , Liver Cirrhosis/pathology , Radioligand AssayABSTRACT
In the present study adrenergic receptors have been investigated in liver parenchyma, obtained at the resection of extrahepatic portal hypertension children without parenchymal affection (control group, n-7) and the resection of children in parenchymal affection (group of chronic hepatitis children, n-6). It has been shown, that the binding of beta-adrenergic radioligand 3H-dihydroalprenolol (3H-DHA) in liver parenchyma membranes of both control and chronic hepatitis groups was saturable and showed high affinity. The Scatchard analysis of the binding data indicated that the binding site was characterized by Kd and Bmax of 1.2 +/- 0.5 nM, 261.2 +/- 50 fmol/mg, respectively, for the control group; and 0.9 +/- 0.15 nM, 68.5 +/- 18.8 fmol/mg, respectively, for the group of chronic hepatitis patients; (mean+SEM). The binding of alpha 1-adrenergic antagonist 3H-prazosin (3H-PRZ) in liver parenchyma was also saturable and showed high affinity. The binding site is characterized by Kd = 0.6 +/- 0.12 nM, Bmax = 92.8 +/- 8.0 fmol/mg, for the control group; and Kd = 0.8 +/- 0.15 nM, Bmax = 195.0 +/- 22.0 fmol/mg, for the group of chronic hepatitis. It has been found that the number of binding sites of 3H-DHA significantly decreased and the number of binding sites of 3H-PRZ did not change in chronic hepatitis liver parenchyma in comparison with the control group. The results obtained suggest the important role of beta-adrenergic receptors in the pathogenesis of chronic hepatitis and in liver regeneration in children.
