[First experience of using cardiorespiratory load testing to assess the functional status of the patient in the pre-operational period].

In anesthetics practice exist different scales and indexes, _through which the evaluation functional condition of the patient. The disadvantage of these scales and tests are subjective evaluation as a condition of the patient, who is able to re-evaluate their functionality and anaesthesiologist, co-tory may underestimate the presence of comorbidities and patient complications in the postoperative period. The method of improvement of objective assessment of the patient's functional reserves, of a cardiorespiratory exercise testing is given. The methodology of testing in 18 patients, who were later performed surgery on the abdominal organs. The definition-of anaerobic threshold was conducted using V-slope method. In all cases was reached and was 11,1 (10,1; 12) mI/kg/min. Maximum oxygen consumption was 15,7 (15,2; 18,3) ml/kg/min. The results show the possibility of using the selected duct la research to predict possible complications and post-operative period.

[HOLDING OBJECTIVE STRUCTURED CLINICAL EXAMINATIONS FOR ANESTHESIOLOGY AND INTENSIVE CARE CLINICAL RESIDENCY IN STATE GRADUATES CERTIFICATION].

The modern system of medical education requires objective methods to assess clinical competence of medical specialists. Application of objective structured clinical examination (OSCE) during the final certification of graduates of clinical residency allows to evaluate the theoretical knowledge, manual skills. Enabling simulation scenarios in the program makes it possible to objectively evaluate the important non-technical skills of anesthesiologists, identify gaps in the system of training and modify it. The experience of the objective structured clinical examination as part of the state certification of graduates of clinical residency of the Department ofAnesthesiology and Intensive Care, Military MedicalAcademy after C M Kirov allows us to consider this technique in an objective way a comprehensive assessment of the competence of health professionals. Students confirmed its highly realistic, they have revealed the presence of emotional stress during the simulation sessions, the majority agreed that the simulation session increased the level of their readiness to address these situations in clinical practice. Staff of the department is planning to testing and introduction rating scales into a system of assessment, to improved exam program, increasing the number of clinical scenarios for simulation sessions.

[Does desflurane have advantages in comparison with sevoflurane at the planned intracranial interventions].

The aim of the study was to compare the effect of sevoflurane and desflurane on the rate of patient awakening from anaesthesia, recovery of orientation, memory and concentration, and the incidence of side effects after elective surgery on the brain. The study included 42 patients, divided into two equal groups. In the first as the main anaesthetic used sevoflurane, in the second - desflurane. Wake-up time, and extubation of recovery of consciousness after desfluranom was less than when using sevoflurane as a anesthetic by 185, 301 and 296, respectively. Time needed for orientation, memory and concentration recovery varied in 15 and 30 minutes (in the desflurane group were faster) after waking up with full recovery in the preoperative level after 2 hours. Using desflurane was not accompanied by deterioration in the operations environment and does not lead to an increase in the number of adverse postoperative phenomena.

[Changes in auditory evoked potentials during abdominal surgical interventions under anesthesia].

The changes in the parameters of average latent auditory potentials (ALAP) were studied in 23 adult patients under anesthesia (ASA II-III) during elective abdominal operations. General combined anesthesia (propofol, fentanyl, and N2O) were used in Group 1 (n = 12), it was combined with epidural anesthesia (lidocaine) in Group 2 (n = 11). General anesthesia was shown to cause a reduction in the amplitude of Pa and Nb peaks and an increase in their latency. Surgical nociceptive stimulation, on the contrary, increased the amplitude of these peaks and decreased their latency. When general anesthesia was applied alone, the magnitude of changes was ascertained to be significantly greater than when it was combined with epidural anesthesia. This suggests that the changes in ALAP reflect the full value and the degree of nociceptive current suppression.