[Comparative characteristics of various anesthetic methods during coronary artery bypass grafting CABG].

During the last 10 years increase in the number of surgical centers developing the practice of off-pump heart surgeries has been noticed. Our medical centre, where 140 CABG surgeries have been performed, is one of the like. Such surgeries demand multicomponent anesthetic manual able to provide adequate depth of anesthesia, hemodynamic stability, prevention of intraoperative myocardial ischemia, providing an early patient activation in a postoperative period. On the assumption stated above we suggest and compare two anesthetic methods - total intravenous anesthesia on the basis of Propofol and Phentanylum and inhalational anesthesia on the basis of Isoflurane for providing CABG Surgery. It has been detected that the anesthetic methods offered by us enable to provide an adequate anesthetic defence while performing CABG Surgeries in case of stable markers of hemodynamics and oxygen transfer functions. Mild hemodynamic disorders have been detected in the operation course first of all at the expense of positional changes and heart immobilization. These disorders have not lead to the deterioration of oxygen transfer functions and have been totally eliminated in the recovery period. Worked-out anesthetic methods on the basis of Midazolam, Propofol, Isoflurane and low doses of Phentanylum (5-7 mcg/kg per hour) give a possibility to decrease the period of artificial lung ventilation, provides an early (less than 6 hours) and safe extubation for 86% of the patients and reduces their stay in a resuscitation unit as well.

[Anesthesia management during the total hip replacement surgery].

Comparative analysis of two methods of anesthesia has been performed to determine the optimal method of anesthesia for total hip replacement. It was revealed that suggested methods - both general (GA) and combined (GA with epidural anesthesia - EA) provide an adequate anesthesia and allow patients with stable hemodynamics and respiratory metabolism undergo various types of major traumatic operations such as THR. Compared with GA, combined multicomponent (GA and EA) has reduced using Propofol by 50% and Fentanyl by 56%. Data from our trials have also showed that combined anesthesia slightly decreased intraoperative blood loss by 10% and there is no evident advantage of using above-mentioned method of anesthesia for this purpose.

[Hemodynamics and gas exchange during spine operations in the prone position].

Hemodynamics and respiratory metabolism of 30 patients in the prone position spine surgery under GA have been studied and analyzed. Results showed that there were no evident hemodynamic changes in patients without any risk of developing cardiovascular complications (ASA I-II). Posture effect of the circulation during anesthesia and spine operation was not marked. Data from our trials did not reveal any deterioration in gas exchange and acid-base balance in patients undergoing surgery in this position (ASA I-II) during adequate artificial respiration lasting 2 hours.

Unusual recurrence of hydatid cysts of the heart: report of two cases and review of the clinical and surgical aspects of the disease.

In cardiac echinococcosis, a hydatid cyst most frequently forms either solely in the heart or in the pericardium, but there are several reports of cysts forming in the liver or lung or in both. In two cases reported here, both patients developed cysts in new sites after one or more previous surgeries for hydatid cyst removal. In Case 1, the patient first underwent spleenectomy and resection of multiple cysts with no evidence of a cyst in the heart; 3 years later, there was no sign of Echinococcus in the liver, but a large inframyocardial cyst had damaged the left ventricle. In Case 2, the patient first underwent surgery to remove cysts from the pericardium, 2 years later from the anterior wall of the left ventricle, and, finally, 8 months after this second operation, from the left atrium also with no evidence of cyst formation anywhere else in the heart at the time of surgery. These cases emphasize the need for thorough and frequent reevaluation to detect new hydatid cyst formation in the heart and elsewhere caused by the Echinococcus organism.